Can You Die From Drug or Alcohol Withdrawals?
Can Drug Withdrawal Cause Death?
While it is true that unassisted withdrawal from some substances, such as alcohol and benzodiazepines, can be deadly, professional treatment provided in medical detox programs can reduce that risk.1 With the proper medical attention and management, withdrawal symptoms can be controlled or mostly eliminated.2
A common question about drug and alcohol rehab and detox focuses on whether the withdrawal process can cause death.
There’s a lot of conflicting information about what types of substances can bring dangerous or deadly withdrawal symptoms. Often, individuals and their loved ones struggling with addiction can be manipulated through fear or lulled into complacency by a lack of accurate information on the dangers and risks of drug withdrawal.
The truth of the matter is somewhat in between. Depending on the situation, withdrawal from some substances can be deadly.1 Still, with professional treatment through medical detox and other supporting therapies, counseling, and education, the risks of withdrawal can be controlled to keep individuals safe and as comfortable as possible through the detox process.
Withdrawal symptoms vary by the substance and the severity of the dependence.2 Three substances that produce uncomfortable and sometimes dangerous withdrawal symptoms include alcohol, benzodiazepines, and opioids.3
Alcohol Withdrawal Symptoms
When an individual, who has chronically misused alcohol, suddenly stops or drastically reduces their intake, they can experience a combination of withdrawal symptoms—both physical and emotional—that can range from mild to severe, and in rare cases, can be life-threatening.2 These symptoms may include:2
- Excessive sweating.
- Hand tremors.
- Increased heart rate.
- Elevated blood pressure.
- Nausea and vomiting.
Benzodiazepine Withdrawal Symptoms
Benzodiazepines are central nervous system (CNS) depressants used to treat anxiety, seizures, and sleeping disorders. Those who take them for extended periods or at higher doses can become dependent on them. When they stop taking benzodiazepines, withdrawal symptoms may appear, including:2
- Agitation and irritability.
- Memory and concentration problems.
- Muscle aches and pain.
Opioid Withdrawal Symptoms
Opioids include highly addictive substances such as heroin, morphine, and oxycodone, among others. When an individual abruptly stops taking opioids, they can experience withdrawal symptoms, that while not life-threatening, can be extremely uncomfortable.2 Symptoms include:
- Nausea and vomiting.
- Hot flashes.
- Cold flushes.
- Muscle cramps.
- Runny nose and eyes.
When Drug Withdrawal Can Be Deadly
Withdrawal from alcohol, opiates, and benzodiazepines can also bring increased risks.2 As a result, clinicians recommend hospitalization or another acute setting that avails 24/7 medical care for safety and general humanitarian concerns regarding comfort.1 Attempting a cold-turkey or at-home detox from alcohol, opiates, or benzos can be dangerous and even life-threatening.1
In addition to the alcohol withdrawal symptoms mentioned above, severe withdrawal from alcohol may include complications such as:2
- Body temperature fluctuations.
- Extreme irritability.
- Delirium tremens (DTs)
The more serious symptoms of seizures and delirium tremens (DTs) can result in death.2 Research indicates that up to 33% of patients who have an alcohol use disorder, the medical term for alcohol addiction, being treated in hospital intensive care units (ICUs), emergency departments (EDs), and critical care units (CCUs), progress to DTs.4
When people, who are struggling with alcohol, withdraw in a medical detox program, the body rids itself of alcohol and other toxins safely and as comfortably as possible. Around-the-clock care also lessens the likelihood that more serious symptoms develop or lead to death.4
The cessation of chronic benzodiazepine use can cause seizures—which can occur without being preceded by other withdrawal symptoms—and rhabdomyolysis, a condition that can be life-threatening, where damaged muscle tissue releases proteins and electrolytes into the bloodstream and can potentially lead to kidney failure.3 Because the severity of benzodiazepine withdrawal symptoms can fluctuate drastically, regular monitoring is advised as individuals safely withdraw from the substance.2
While opiate withdrawal symptoms can be extremely uncomfortable, they are typically not life-threatening. What can be dangerous, however, is the risk of relapse. Studies indicate that individuals with opioid use disorder, who follow detoxification with complete abstinence from the substance without using medications can have a high likelihood of relapse.5 Relapse rates can potentially be decreased if individuals in recovery from opioid use disorder use prescribed medications to reduce the lingering withdrawal symptoms and cravings with long-term therapy.5
Another danger for those experiencing opioid withdrawal symptoms is the promise that some outpatient clinics make for “rapid drug detoxification.” This questionable practice is an anesthesia-assisted opioid detox that uses a combination of sedation and medication to remove opioids from the body.6 However, a number of case reports found adverse effects following rapid detoxification in some individuals.7 Additionally, research indicates that this form of treatment is not effective for long-term recovery, and it is more likely to result in relapse.6
Instead, medically managed detox, followed by a formal treatment program that uses evidence-based therapies, individual and group counseling, education, and medication is more likely to result in safe recovery and long-term abstinence from the drug.8
Risks from Multiple Addictions
The aforementioned detox risks multiply with polysubstance (the use of more than one substance) misuse.1 When multiple drugs are involved, withdrawal management may become more complicated. For example, when a person withdraws from one substance, clinicians can predict with pretty good accuracy the symptoms they may encounter.1 When more than one substance is involved, that’s not the case. In a supervised detoxification environment, such as an inpatient or residential facility, an individual can receive immediate care for unexpected symptoms should they arise.1
Additionally, during managed withdrawal, healthcare professionals prioritize each substance and address the most serious withdrawal symptoms first.1
Relapse and Overdose
The potential for relapse constitutes another risk of drug withdrawal. During the withdrawal process, tolerance to the addictive substance lowers significantly; however, the habitual cravings often remain the same. This means that what would have been a tolerable dose before detox becomes an overdose risk afterwards.5
This is a major risk with opiates.5 In this case, an overdose of heroin or prescription opiate drugs can interfere with the respiratory system and cause a person to stop breathing. More than 75,000 people in the United States died as a result of an opioid overdose during the 12-month period from April 2020 to April 2021.9
Relapse danger is complicated further if there are multiple relapses, as withdrawal symptoms can become worse with each successive detox, increasing the chance that a more severe reaction will occur.1 This is true in alcohol withdrawal, where several factors impact the severity of the withdrawal, including the number of previously treated and untreated withdrawal episodes.1
Based on this, methods of detox that are more likely to result in relapse are also more likely to result in medical complications or even death. Methods such as the anesthesia-assisted detox mentioned above and quitting cold turkey don’t provide the support that is more likely to result in long-term recovery. One study found that individuals with alcohol use disorders, who quit on their own, were less likely to achieve 3-year remission than individuals who received treatment.10
An inpatient treatment program provides tools and support to help individuals avoid relapse and maintain long-term recovery.8
Diminishing Deadly Risk
The safe, compassionate methods used during inpatient detox helps an individual rid their body of the substance, but detox is only the first step in a more comprehensive treatment plan.8 A complete addiction treatment program focuses on helping an individual get to the root of their addiction by addressing the thoughts, emotions, and behaviors that led to substance misuse. Through evidence-based therapies and counseling, individuals learn coping strategies.8
The most effective treatment tailors the treatment plan and services to meet the needs of the individual, addressing the substance misuse and any other issues, including co-occurring disorders to help individuals find and maintain long-term recovery.8