CAN YOU ACTUALLY DIE WHILE DETOXING FROM ALCOHOL?
Absolutely. When a person is dependent upon alcohol, an alcoholic, the body gets accustomed to having the alcohol in the blood stream and accommodates to having it there. When the person stops drinking the body detects this as a deficiency and reacts to it causing both mental and physical problems which can be mild or serious and life-threatening.
Since alcohol acts like a depressant in the system, slowing down the brain for example, when it is withdrawn it causes an opposite effect. This is because the brain works hard to keep a certain level of activity or alertness up in the presence of alcohol.
The adjustment to stay up or activated persists past the last drink and the brain is activated, hyperactive in a sense. How hyperactive the brain and body are after the last drink depends upon how much you have been drinking over what period of time.
The daily drinker he may wake up with shaky hands, high blood pressure, and anxiety which is eased or eliminated after the first drink of the day- often called an eye-opener.
If you have a loved one who wakes up to a Bloody Mary every day, or cold vodka from the freezer, he may be an alcoholic trying to ease his morning withdrawal. Other signs and symptoms include sweating, headache, nausea, vomiting, and insomnia or disturbed sleep.
The problems that arrive after you stop drinking if you are an alcoholic come on about six (6) hours after the last drink for most. If you have a severe problem with alcohol you can actually have withdrawal when you reduce the amount you drink.
Most people are aware the alcohol withdrawal can cause seizures which are due to extreme activity of the brain without a purpose. This is a serious sign and NO ONE should be allowed to have seizures from alcohol withdrawal as brain cells die off and the patient can die too! If you are shaky when you stop drinking, see a doctor for medication assisted or managed withdrawal.
The most severe form of withdrawal is seizures with hallucinations seeing things, feeling things, or hearing things- call delirium tremendous (DTs). Olfactory hallucinations smelling things that are not there- are a very serious sign too.
Do not wait to call 911 when your loved one complains of any of these kinds of hallucinations as they can have a seizure which can not be stopped by medications and the brain consumes more oxygen than the blood can carry which results in death.
A very small percentage of people get DTs since most withdrawal is treated with medications. When it occurs it is also associated with delusions, confusion, fast heart beat, high blood pressure, fever, and heavy sweating.
Do not let alcohol withdrawal progress to these end stage forms of withdrawal- anxiety, pacing, craving, and high blood pressure and hear rate are warming signs to get medical care.
People who have had seizures once are more prone to get them again and high blood pressure and heart rate can cause stroke or heart attacks. The older the person and the more heart and lung problems he has, the more serious and life-threatening the withdrawal.
HOW MUCH OR HOW OFTEN TO YOU HAVE TO DRINK BEFORE EXPERIENCING PROBLEMS FROM QUITTING?
The amount that you have to drink or the amount of time you have to drink without stopping before you will have withdrawal varies from person to person. If you drink daily around the clock, only stopping to sleep, you can expect to have problems when you stop after only six weeks of regular exposure.
This changes if you take sedatives, sleeping pills, or muscle relaxants. The presence of the pills can mask the withdrawal so you do not know that when you stop you go into withdrawal. But, if you stop the pills to, or even reduce your dose, you can have withdrawal.
HOW IS ALCOHOL ADDICTION DIAGNOSED?
A doctor can diagnosis alcohol use disorders, including alcoholism, using a combination of history taking and physical exam. We often look for consequences of regular use like liver disease, sleep disturbances, or heart rhythm problems. Alcoholism is called the “great masquerader” since exposure to alcohol over time can cause damage to major organs in the body and mimic, or look like, other diseases. This makes it hard to diagnose.
In general, we have a way to assess problems associated with alcohol, and drugs and we can count the number of problems.
- More time spent using than predicted when you started using during an episode
- Desire to stop but unable to
- Using over time, getting something to use, using, recovering from using and starting the cycle over again every day
- Preoccupied with alcohol
- Use interfering with life’s activities
- Using, despite consequences
- Using interferes with activities that you like to do
- Use in dangerous situations, like while driving
- Need to use more to get the same effect (tolerance)
- Negative consequences when use stops (withdrawal)
- Use after a bad episode
If you can endorse 6 or more things, you have a severe problem. It is moderate if you endorse 4 or 5 and mild for 2 or 3 problems.
WHY IS WITHDRAWAL FROM ALCOHOL MORE DANGEROUS THAN OTHER SUBSTANCES?
Alcohol withdrawal is life-threatening. The drugs make you sick but the adult will generally not die from withdrawal. Opioid, or heroin and fentanyl withdrawal, can kill the unborn fetus.
WHAT IS THE PROPER WAY TO DEAL WITH ALCOHOL ADDICTION?
Treatment by a professional – starting with the physician to detoxify you. After you are medically stabilized, you should seek counseling.
Treatment progresses at Two Dreams through three phases- coming in where we take a factual history of what happened; looking inward where we do the emotional work and look at the emotional impact of what has happened; and looking out where we put a plan into action to build on the gains made in treatment.
Additionally, Alcoholics Anonymous (AA) is widely available and people who go to three or more meetings a week after treatment do better than those who go to two or fewer. In AA there is a saying, “don’t drink and go to meetings!”
Dr. Barthwell answers your questions on the next page.
I’m an alcoholic who recently visited the hospital for pneumonia and stayed in the hospital for 3 days. I have often prayed that God would take this away from me and I think he has I have not desired a drink since Thanksgiving. What type of problems should I expect as a sign of withdrawal from my alcoholism?
The signs and symptoms of withdrawal are in this article above. But, if you have NOT had a drink of alcohol since Thanksgiving, you are past the point that we would see withdrawal. This could be different if you take sleeping pills or sedatives or muscle relaxants.
The long term effects of your alcohol use may still show themselves. You could have brain damage with memory loss, heart damage, liver damage, or problems with your blood pressure. Please see your doctor for an examination to make sure you are OK. You may also have craving that comes back and want to have a plan in place to deal with the desire to drink. I suggest you check out AA.
Is there a placebo alcohol beverage?
No. There are low alcohol content beers, but I do not recommend that an alcoholic who is trying to stop drinking use them.
Does this include wine?
NO.
Q: I don’t drink throughout the week (Mon-Thurs.) but I’ll have several drinks on the weekends. (3-4 each day) I do have high blood pressure, & Type 2 diabetes. I take medicine to control both, have changed my eating habits, and exercise. My mother, who does not drink, also has high blood pressure and diabetes. Are my symptoms from heritage or alcohol?
They could be from both working against the medication you take to control your diseases and the long-term health effects of them both. Please consider stopping to see if you can get better control over both diabetes and your blood pressure. If you can’t stop without help, it could be a sign that the alcohol is more important to you than you think.
Is it possible to get almost deathly ill from one drink of alcohol at age 40?
Yes. There are two ways. There are some people who lack a chemical in their body to destroy the alcohol and when trying to break it down. A very toxic chemical stays in the blood stream. This chemical can cause flushing, high blood pressure, heart rhythm problems and death! People generally know if they have this problem, because a small sip of alcohol causes them to flush and get hot.
The second way is because of chronic alcohol exposure that has led to a problem with the liver and an inability to handle a drink.
A different possibility comes from something other than the alcohol. A person who drinks alcohol laced with something else can get very ill from the drink. This is why we recommend being careful to guard your drink in a public drinking place (a bar) to avoid being poisoned with the “date rape drug” or other contaminants.
How do you know if you’re having withdrawal and not a hangover? What are the symptoms of withdrawal?
A hangover occurs after a night of drinking and is caused by being sick from taking a lot of alcohol during one episode of drinking.It is defined by the headache, body ache, stomach upset, and general feeling of being tired, weak, and confused.
The hangover can be addressed with rest and anti- inflammatory medication (aspirin, acetaminophen, ibuprofen, etc.) for the headache. Sometimes putting something in the stomach can calm it. Be careful with taking aspirin, because it can make the stomach upset worse or irritate the lining of the stomach and cause ulcers or bleeding in the person who uses a lot of alcohol.
Part of the hangover is also due to being dehydrated. Alcohol causes you to increase your urine and you can get dry or dehydrated while drinking, since you will urinate more than you are taking in. It is important to drink a glass of water for every cocktail, glass of wine, bottle of beer during the night and re-hydrate with a balanced water the next morning. But the MOST important thing to pay attention to is to NOT drink too much in one setting so that you can avoid the hangover in the first place.
Having hangovers the morning after drinking is a sign that you are drinking too much and you are at risk for more health problems due to your drinking. We recommend no more than 3 drinks per episode for a woman and 5 for a man over as many hours. We also recommend no more than three drinking nights a week.
As to withdrawal: When a person is dependent upon alcohol, an alcoholic, the body gets accustomed to having the alcohol in the blood stream and gets used to having it there and has to make adjustments to your drinking. When the person stops drinking, the body detects this as a deficiency and reacts to it causing both mental and physical problems which can be mild or serious and life-threatening.
Since alcohol acts like a depressant in the system, slowing down the brain for example, when it is withdrawn it causes an opposite effect. This is because the brain works hard to keep a certain level of activity or alertness in the presence of alcohol. The adjustment to stay up or activated lasts past the last drink and the brain is activated, hyperactive in a sense. How hyperactive the brain and body are after the last drink depends upon how much you have been drinking over what period of time.
The problems that arrive after you stop drinking if you are an alcoholic come on about six (6) hours after the last drink for most. If you have a severe problem with alcohol you can actually have withdrawal when you reduce the amount you drink.
Most people are aware the alcohol withdrawal can cause seizures which are due to extreme activity of the brain without a purpose. This is a serious sign and NO ONE should be allowed to have seizures from alcohol withdrawal as brain cells die off and the patient can die too! If you are shaky when you stop drinking, see a doctor for medication assisted or managed withdrawal.
The most severe form of withdrawal is seizures with hallucinations- seeing things, feeling things, or hearing things- call delirium tremendous (DTs). Olfactory hallucinations- smelling things that are not there- are a very serious sign too. Do not wait to call 911 when your loved one complains of any of these kinds of hallucinations.
A very small percentage of people get DTs now, since most withdrawal is treated with medications.
Do not let alcohol withdrawal progress to these end stage forms of withdrawal- anxiety, pacing, craving, and high blood pressure and hear rate are warming signs to get medical care.
People who have had seizures once are more prone to get them again and high blood pressure and heart rate can cause stroke or heart attacks. The older the person and the more heart and lung problems he has, the more serious and life-threatening the withdrawal.
Head to the next page for more about identifying alcoholic behavior and what AA treatment is like.
Wow. Had no idea that could cause so many issues and even death. Do they talk about that in AA?
Yes, people talk about their strengths, experiences, and hopes in AA. They are NOT there to advise you medically, or even teach you about your disease except through sharing their own experiences. You can learn a lot at AA but for more information go to the National Institute on Alcohol Abuse and Alcoholism (https://www.niaaa.nih.gov/). There are many, may resources there about alcohol, alcoholism, and self-tests.
I feel like I have to have a 4-pack or more a day. What do I do, because I think I may be a functioning alcoholic.
You should explore the problem on my website, the government’s web site about alcoholism or Alcoholics Anonymous web site. All of the AA literature is available online. I would also like to call your attention to this piece about Blacks and alcohol.
People put a lot of stock in calling out a difference between an alcoholic and a functioning alcoholic. That’s like the difference between a person with cancer or a person with cancer who is still working. The diagnosis is the diagnosis and just because you are not falling down drunk in the street, homeless and hopeless, does not mean that the diagnosis is not as serious. It is. Please get more information and seek help.
Does cirrhosis of the liver only come from alcoholism?
A: No, cirrhosis is a description of liver disease from an number of causes, however, cirrhosis in the United States is generally caused by heavy alcohol use and chronic hepatitis C (which can be caused by sharing needles). Obesity is also becoming a major cause of cirrhosis.
Cirrhosis develops when scar tissue replaces normal, healthy tissue in the liver. Healthy cells are damaged by alcohol exposure that causes the cells to be inflamed and promoting fat deposits in the liver.
The illness progresses when the sick cells form scar tissue which makes the liver lumpy and hard. As scar replaces normal cells, the normal tissue in the liver shrinks and the liver cannot do its job- which is to filter the blood stream and let the body eliminate medications and other byproducts of life. The scar also makes it hard to filter the blood and blood gets backed up trying to be forced through the shrunken, tight organ.
When blood gets backed up it causes varicose veins around the stomach and in the esophagus. These veins can rupture when an alcoholic vomits or throws up and the alcoholic may bleed out and die.
The National Institutes of Health has set limits to consider to avoid developing cirrhosis. Various studies suggest that a woman should limit her drinks to three (3) and under per drinking episode and men to five (5) and under. The fewer you drink, the safer it is.
Doing shots is not a safe thing for your liver because, even if you allow yourself on one occasion per week to go up to these limits, you should NOT drink more than one drink per hour. Be sure to drink plenty of water over the course of the night. I recommend one 8 ounce glass of water between every serving of alcohol.
Is there such a thing as an alcohol dementia-related disease?
Yes, alcohol-related dementia is due to long term chronic exposure to alcohol with damage to the brain and loss of thinking (cognitive) function. The specific brain function loss from alcohol exposure has to do with thinking, reasoning, loss of inhibition (not being able to hold back and respond to social cues about what is right and appropriate). The reason it is in the class of dementias is that it is long-standing.
This is NOT to be confused with loss of inhibition due to drinking which causes people to make BAD decisions due to drinking and intoxication (like going home with a stranger and potentially putting oneself in a dangerous situation, driving while intoxicated, etc.). In that case, the ability to be reasonable is not lost and returns when one sobers up.
I drank 10-12 beers a day for 15 years and now am down to 3-4 a day. Am I putting myself in danger by weaning?
It is always safer to go to a professional and have them measure your body’s response to the changing exposure to alcohol and control the taper with medications, but, if you have done this safely, then congratulations to you. Now, you should really, really consider going to a professional to get off alcohol completely.
Andrea Grubb Barthwell, M.D., D.F.A.S.A.M., is the Founder and Director at Two Dreams Outer Banks, a comprehensive wellness center for the treatment of alcoholism and substance use disorders. Dr. Barthwell received a Bachelor of Arts degree in Psychology from Wesleyan University, where she served on the Board of Trustees, and a Doctor of Medicine from the University of Michigan Medical School.
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