The Risks of Quitting Cold Turkey

Quitting substance use suddenly and abruptly, or "cold turkey," carries very significant risks if the drug you are discontinuing is alcohol, a benzodiazepine, or an opiate. It is also not advisable if you have been using any drug in large amounts and/or for a long time, because what you have been using may contain one of the high-risk drugs mentioned, or because you may suffer from extreme withdrawal symptoms.

The Appeal of Quitting Cold Turkey

For many people who are addicted to alcohol or drugs, quitting cold turkey is more appealing for a number of reasons. One is because it can be easier to avoid the drug entirely than to use it moderately when your usual mode is to take the drug in an unrestrained manner.

Many feel that they can more easily separate themselves from the world of drug use if they do so completely, avoiding all of the people, places and other reminders of the drug and starting afresh.

Risks

Quitting can be dangerous to do on your own because of the way the nervous system adapts to certain high dependency drugs. Abruptly taking these drugs out of your system can cause a variety of serious and potentially life-threatening medical conditions, including seizures and heart problems.

Developing delirium tremens (DTs) is the main risk of alcohol withdrawal. Also known as alcohol withdrawal syndrome, this complication can occur when people suddenly stop consuming alcohol. It is more likely to occur following long-term, heavy alcohol use and is potentially fatal. It has a mortality rate of around 5%.

Symptoms of acute alcohol withdrawal typically begin 6 to 24 hours after a person has their last drink. Some of these symptoms may include:

• Loss of appetite
• Nausea
• Tremors
• Increase heart rate and blood pressure
• Irritability and restlessness
• Delusions
• Hallucinations
• Seizures
• Hyperthermia

While the progression of symptoms varies from one person to the next, the severity of their symptoms can predict the risk of death.

Even drugs that have less pronounced physical dependence, such as cocaine, amphetamines, and nicotine, can produce severe and unpleasant withdrawal symptoms that can make life uncomfortable and emotionally difficult.

Medical Supervision for Drug Abstinence Is Safest

This does not mean you can't become abstinent, but especially if you are quitting alcohol, a benzodiazepine or an opiate, you should quit under the management of a physician, who can give you medication to lessen the effects of withdrawal. Doctors affiliated with the American Board of Addiction Medicine have special training in addiction medicine and are particularly helpful in managing withdrawal safely.

In many cases, a brief time in detox can be the safest option so that medical staff is on hand in case of a medical emergency. The staff can also help with providing nutrition, hydration, and medications intravenously if you are suffering from significant nausea, vomiting, or diarrhea during your withdrawal.

However, many people are able to detox safely at home or in the community while meeting regularly with their doctor or health professional to ensure they remain well throughout the process. Your doctor may prescribe you different medications depending on the drug you are withdrawing from.

When to Call 911

The risks of withdrawal from alcohol are much greater than they are for other substances. In particular, alterations in consciousness can be a critical symptom of delirium tremens.

If you or someone you know is showing signs of a heart attack, seizure, or changes in consciousness while quitting cold turkey, call 911 immediately. Symptoms of a heart attack may include:

• Shortness of breath
• Chest pain
• Pain or discomfort in the jaw, neck, or back
• Weakness, lightheadedness, or faintness
• Pain or discomfort in the arms or shoulder
• Nausea
• Vomiting