Risks and Dangers of Quitting Alcohol Cold Turkey

What Happens When You Stop Drinking Cold Turkey?

More than 28 million people aged 12 and older had an alcohol use disorder in 2020, a medical condition defined by the uncontrollable use of alcohol despite the negative impact on an individual’s physical and mental health and their relationships with family, friends, and others.^1,2  Excessive, regular alcohol consumption can result in structural and functional changes within brain circuits involved in reward, stress, and self-control, which can lead to the compulsive patterns of use characteristic to addiction.²

Research indicates that about half of individuals with an alcohol use disorder who suddenly stop drinking or drastically reduce their alcohol intake experience a set of symptoms known as alcohol withdrawal syndrome.³

Alcohol Withdrawal Symptoms

The signs and symptoms of alcohol withdrawal may include:^3-5

• Sweating.
• Rapid heart rate.
• Heart palpitations.
• High blood pressure.
• Headache.
• Insomnia.
• Nausea and vomiting.
• Hallucinations.
• Anxiety.
• Agitation.
• Tremors or shakes.

More rarely, if left untreated or inadequately managed, withdrawal can progress to violent seizures, delirium tremens (DTs), and death.³

What specifically happens in your body when you abruptly cease drinking depends on a variety of factors. How much, how often, and how long alcohol was consumed affect the severity of the withdrawal symptoms.⁴ Additionally, older adults, those with a past history of alcohol withdrawal seizures, and individuals with comorbid physical or mental health conditions may be at risk of experiencing more severe alcohol withdrawal symptoms.⁶

Alcohol Withdrawal Timeline

While exact timing differs from person to person, alcohol withdrawal syndrome typically begins within 6 to 24 hours after the last drink of alcohol and can last for days:⁵

• During hours 6-12, relatively milder withdrawal symptoms set in. These may include insomnia, tremors, mild anxiety, stomachache, headache, excessive sweating (diaphoresis), heart palpitations, and loss of appetite.
• During hours 12-24, hallucinations may occur.
• During hours 24-48, the risk for seizures is at its highest, should they develop.
• During hours 48-72, the risk for developing alcohol withdrawal delirium (or DTs) continues into the third day, with symptoms such as psychomotor agitation, hallucinations, disorientation, rapid heart rate, high blood pressure, fever, and sweating.

For those with alcohol dependence, quitting is not without risks. Acute alcohol withdrawal may be associated with certain medical complications. At American Addiction Centers (AAC), we offer the 24-hour supervision and care during medical detox. We can help you get through the withdrawal process safely and with the aid of medical professionals. Call one of our admissions navigators at .

Other Dangerous Side Effects of Alcohol Withdrawal

Other common issues seen in those experiencing alcohol withdrawal include dehydration, electrolyte imbalances, and malnutrition—all of which could lead to serious medical complications.⁵ Electrolyte imbalances, for instance, can cause an irregular heartbeat. Malnutrition, which is common in those with alcohol use disorder, can result in significant thiamine deficiency, which could result in Wernicke-Korsakoff syndrome (WKS).⁵ WKS is actually two separate syndromes: One is a temporary but severe condition known as Wernicke’s encephalopathy, marked by confusion, optic nerve paralysis, and muscle coordination problems. The second condition is the persistent and disabling Korsakoff’s psychosis, which results in long-term memory and learning problems.⁷

Alcohol Withdrawal and Detox Treatment

Alcohol withdrawal can be intense and uncomfortable. Due to the risk of severe symptoms and alcohol withdrawal complications such as seizures, many people benefit from the stable environment and professional help provided by medical detox, which can provide pharmaceutical tools and medications to help eliminate or reduce specific symptoms of alcohol withdrawal.

In a medical detox program, which is often the first step in a longer-term treatment plan, you check into a specialized facility where you will be closely monitored by healthcare professionals to keep you as safe and comfortable as possible as your alcohol withdrawal is managed.⁸ Medications such as relatively long-acting benzodiazepines may be used to manage acute alcohol withdrawal and mitigate the risks for withdrawal complications such as seizures.⁶

Studies indicate that a fixed tapering regimen—gradually decreasing doses of benzodiazepines at fixed intervals regardless of symptom severity—can be a beneficial outpatient option in cases where closer monitoring may not be necessary or possible.⁶

While detox is an important first step, it may not be enough to support an individual’s long-term recovery from alcohol addiction. To maintain recovery over time and avoid relapse, ongoing treatment can more comprehensively address your underlying thoughts, emotions, and behaviors that led to the alcohol misuse in the first place. An evidence-based alcohol addiction treatment program can help you learn the skills needed for lasting recovery.⁸ Treatment looks different for everyone but might include behavioral therapies, counseling, mutual-help group participation, medications, and complementary therapies.

Benefits and Tips for Quitting Alcohol

Quitting drinking (safely) may improve or reverse some of alcohol’s negative effects on your physical health, including improving or reversing cognitive damage, lowering blood pressure, reversing some forms of alcohol-related liver injury, and reducing the risk of certain cancers each year you’re sober.^9,10

Some effective strategies to help you on your long-term recovery journey include:^11,12

• Learning to say no. If drinking has been a large part of your life, you’re likely to encounter situations where alcohol is present. You might even be offered a drink. Plan for these scenarios. Drink refusal skills can be helpful. Role play situations like this with supportive friends so you’re prepared.
• Find alternate ways to occupy your time. Replace alcohol-centered activities with healthier ones. Spend time with friends, take up a new hobby, learn a new skill, or exercise.
• Avoid high-risk situations. Identify your trigger scenarios and avoid them if you can. If you can’t, bring supportive friends or family who can help you cope with the temptation.
• Ask people for help. Talk to peers, doctors, therapists, and others in similar situations for strategies and tips for avoiding alcohol.
• Join a support group. Mutual-help groups such as Alcoholics Anonymous (AA) can provide support, comfort, and techniques to help you stay sober.