Alcohol, benzos, and opiates – Withdrawal that might kill you

Along with teaching and telling stories, part of my goal here at All About Addiction is to get important information out to those who can benefit from it.

Most drug users who quit drug use “cold turkey” have to go through withdrawal of some sort. Withdrawal is never comfortable, but sometimes it can actually be dangerous. The list below outlines some drugs that should NEVER be quit suddenly without medical supervision. This is the reason why some rehab treatment is preceded by a medical detox period lasting anywhere from 2 days to a week or more.

Which withdrawals can actually kill?

  1. Alcohol – Yes, after long term use, withdrawal from alcohol can kill. Alcohol withdrawal syndrome can take on mild, moderate, or severe forms. If while withdrawing from alcohol a person develops a fever, extreme nausea, diarrhea, or DT (delirium tremens), they need to be rushed to see a doctor as soon as possible. In fact, alcohol withdrawal after heavy, chronic use is best managed under the care of a doctor or a professional medical detox unit. By using medications that relieve withdrawal symptoms, these professionals can essentially eliminate any of these risks.
  2. Benzodiazepines – Benzos were introduced as a replacement to barbiturates that were causing common overdose cases, many of which resulted in death. Nevertheless, withdrawal from extended use of benzodiaepines can kill. Whether Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam) or other variations, long term use of Benzodiazepines requires medical supervision to be completed successfully with minimal side-effects and risk to the patient. Normally, the withdrawal process is managed by slowly reducing the dose and transferring the patient from a slow acting, to a long acting, form of the drug. Still, full resolution of benzodiazepine withdrawal syndrome can take up to 6 months (or even longer).
  3. Opiates – Many people are surprised to learn that in most cases, withdrawal from many opiates is not deadly. Still there are some very important exceptions. Methadone, a long-acting opiate often prescribed as a replacement for heroin can cause death during withdrawal if it’s consumed in high enough doses for a long enough period. The debate of whether the state should be prescribing something like this should be saved for a later date. It is one of the better ways of getting people off of heroin, though obviously, all it does is replace dependence on one substance with another, more manageable one. Also, some of the recently popular methods of rapid-detox from heroin addiction can themselves cause death, and many other negative side-effects. Overall, I would recommend checking in with a physician and conducting opiate withdrawal in a controlled setting. Withdrawal under Suboxone or Subutex can be far less horrific.

Much of the danger in withdrawal from all of these drugs has to do with the body’s response to the extreme changes in the chemical processes going on in the brain and the rest of the body. Alcohol, Benzos, and Opiates interference with the GABA system, the body’s most common downregulator.

Withdrawal from these drugs is like trying to turn the heat up in a cold house with a broken thermostat and an out of control heater – It won’t always lead to disaster, but it’s a bad idea.

The withdrawal danger summary

That’s pretty much it. “Cold Turkey” withdrawal from cocaine, marijuana, crystal meth, ecstasy, GHB (never mix GHB with alcohol though!!!), and many other recreationally used drugs will not lead to death in the vast majority of cases. While it may make you uncomfortable, and you may feel moody, constipated, dehydrated, hungry or nauseous, and a whole slew of other symptoms, the chances of someone actually dying from withdrawal are very small.

If you have any more specific questions regarding your case though, don’t shy from asking me!

23 responses to “Alcohol, benzos, and opiates – Withdrawal that might kill you”

  1. Addiction, violence, civil liberties,crack cocaine, poverty, 2010 Olympics, drugs, prostitution, heroin, homelessness; and their impact on Vancouver’s Black Eye, The Downtown Eastside.

    More than 2 million syringes are handed out free every year. Clean mouthpieces for crack pipes are provided at taxpayers’ expense. Around 4,000 opiate addicts get prescription methadone. Thousands come to the injection site every year.

    addiction is a state in which the body relies on a substance for normal functioning and develops physical dependence, as in drug addiction. When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms. Addiction is generally associated with increased drug tolerance common usage of the term addiction has spread to include psychological dependence. In this context, the term is used in drug addiction and substance abuse problems

    Impelled by the horror show of the Downtown East Side, prodded by activists and convinced by reams of academic studies, the police and city government have agreed to provide hard drug users with their paraphernalia, a place to use it and even, for a few, the drugs themselves.

    The Harsh Reality of Drug Addiction

    Not for the faint-hearted, this video is graphic and shocking and shows the depths of depravity that the human soul can descend to.

    After 11 months of sobriety from cocaine, heroin, methamphetamine and other drugs this individuals mental state has sunk to an almost animal-like existence.

    2010 Homeless Champions supports The Servants of Hope Recovery House

    a proven model of recovery recently acknowledged by Operation Phoenix and the Vancouver Province Newspaper

    This website is dedicated to telling the stories of the unfortunate individuals living in the Downtown Eastside of Vancouver in the hope that awareness of this problem will spur people to get involved, to let all levels of government know that something has to be done to alleviate this misery rooted in addiction, homelessness and depravity. To point the way to recovery from addiction, which we believe is the root of most of this situation. With the 2010 Olympics coming to Vancouver it is our mandate to record the transition and the extreme changes that are even now occurring and will continue to unfold in the Downtown Eastside.

  2. Wow I dint know this my BF has tried many times to quit on his own cold turkey is a meth addict and when he is feeling sick he experiences alot of abdominal pain why is this?? also what do the drug rehab programs offer?

  3. Wow I dint know this my BF has tried many times to quit on his own cold turkey is a meth addict and when he is feeling sick he experiences alot of abdominal pain why is this?? also what do the drug rehab programs offer? he has never been in one.

  4. Hi Esmeralda,
    I’m not sure why your boyfriend experiences abdominal pain when withdrawing from meth. While meth withdrawal can be uncomfortable, it normally includes a lot of sleeping and eating since the body has been starved of both for quite a while. Perhaps his stomach issues are related to things like ulcers due to stomach acids.
    Rehabs offer medicated withdrawal to ease the pain, although this is mostly offered for people withdrawing from heroin or other opiates, benzos (like valium), or long-time alcoholics.

    How is your boyfriend doing now? Is he still managing to stay clean? What ever happened with the insurance?

  5. Where can I go to find information about the degree of consumption and the likelihood of medical issues. I have been drinking every night for about a year and it is my new year’s resolution to quit, but now I’m worried that I might need medical help to do so after reading this. I don’t drink during the day, just at bed time, but I have about 3 drinks so basically I end up passing out. Is this a medical treatment deal, or am I safe to just quit and maybe take xanax for a week?

    • Hey Mike, great question and good job doing some research before going further. Though I have to recommend that you see a doctor before making a final decision, given what you’ve told me (3 drinks per day for a year) I would say that you’re safe to quit without much of a problem or need for medical supervision. Believe it or not, there are people out there who get to the point of drinking a fifth of liquor (think whole bottle of vodka) every day. those are the type of individuals that definitely need supervision and most likely pharmaceutical help, to quit. Anything around and up to 3-5 drinks per day I would say can have a go with little more than determination. I would actually stay away from the xanax and brave the first week, difficult as it may be. If after that first week you still finding yourself anxious without the alcohol, definitely go to see a psychiatrist.

      Good luck and all the best man – Keep me updated!

  6. Something that is rarely mentioned is the use of methadone as a detox med from heroin. I am clean now but had a period of about 18mths when I couldnt quite leave heroin behind and went on it and off it, each time I came off I used methadone as a detox med. I planned my own detoxes based on experience and research buying meth on the street but found that even with a fairly moderate habit (2grams heroin/day) I could be free of the worst of the withdrawals after only a week on a reducing amount of methadone. Effectively one week and its all over apart from some leg discomfort, I have never had a methadone habit and wouldnt want one, in fact finance and circumstances permitting I would go so far as to suggest that it would be better to titrate from methadone back to heroin to get the meth out your system then detox back off the heroin using meth for a week as I have described.
    Methadone is a terrible substitute but an excellent detox med.

    • Actually Barry, the original thinking behind methadone was to use it as a transition drug for short term detox from heroin. Unfortunately, it’s simpler, and more profitable to simply use it as replacement… I wish more methadone clinics refocused their efforts on methadone detox, not maintenance.

  7. It is a shame that it has become a tool of management certainly in the UK its administered under the guise of ‘harm reduction’, something of a misnomer.
    There is change coming with a focus on abstinence rather than management, I think the authorities realise that having people on meth scripts for years and years isnt the answer but still the use of it as a detox med doesnt seem to occur to anyone. The thinking here now is that one year on a script, be it subutex or methadone is the aim. A year on subutex isnt a great idea either.
    I didnt realise that it was originally intended as a short term detox med though, I do find it hard to understand why it isnt used more for that, and of course its easy to use heroin on top, which many do ending up worse off.
    It is an imperfect world but knowledge and communication help and I am glad that people such as yourself are working so hard.
    The big problem we have in the UK now are so called ‘legal highs’ really powerful chemicals that are becoming as common as cigarettes, classifying them as illegal is too little too late and that will all come home to roost in a few years time. I dont know the answer to that, as a species we are embracing drugs of all kinds, the addicts of tomorrow are already here and there are more each day.

  8. I have a Stepson in a treatment center due to benzos. They had him in detox for about 17 days..the detox was with pheno. They moved him to the rehab section which after a day went into a melt down. They moved him back to the detox section and had what they call sitters with him because he threatens suicide. They will not give him anymore meds not even an aspirin. It has been about 7 or 8 days that he has been completely off all meds. His withdrawals he describes as agony and is begging for pain medication. He was on benzos for about 2 years….Are we doing the right thing? It is a very safe place and they watch him 24/7. This is the 5th treatment center and he 57 years old.

    • Hi Robin, as far as I know, benzo withdrawal is normally slower than 17 days, but that depends on dosage and other factors. If you have insurance, I would look into doctors who are familiar with the problem. Where are you located?

  9. We are in SC and this guy has no insurance. We are retired. This is a very expensive treatment center that we have to pay for. He is having lots of panic attacks and begging to get out. I am not sure if anybody can help him.

  10. I was addicted to opiates/benzos. I tried to quit several times but I couldn’t because of the withdrawals and still hanging around the same group of friends that did them so that didn’t help either. After a year of doing it all day everyday and doing stupid stuff to get them or getting busted by the police I realized I needed help before it was too late and my life was gone. So me and the girl I considered my best friends went to the methadone clinic since I wanted help and she did too since she was prego. Well the day I started the clinic they said I couldn’t take anything or I would stand a high chance of overdosing and dying. As soon as I got my dosing and went out to the car they already had a pill broke down so I did it and take a xanex bar and I was out of it and they gave me more pills when I didn’t know what was going on. So I overdosed and the nurses said another pill would’ve killed me. So I agreed to just go to rehab. But that was three days after I overdosed that I was starting rehab and it was weird because I had no withdrawals other than hot sweats and trouble sleeping and the cravings, so I chose to not go to rehab to just do it on my own. So I just quit talking to the same group, changed my number and getting a new car so none of them try and contact me. Today is 44 days of being without pills. But everyday I still have the cravings and I’m worried I’ll go right back to doing them again but right now I’m trying to be as strong as I can. But is there anyway I can go to the doctor and get soboxone? Or would they say I came to late to get on it since I didn’t earlier in my recovery.

  11. I am about to embark on a cold turkey withdrawl from 45mls of Methadone. I take into account everything Ive read above, but the slight chance of dying while trying to clean my act up seems acceptable to the almost certainty of dying in some drug den somewhere, I feel like its make or break time for me. I have plenty of family support around me and plenty determination, but would stil appreciate if anyone who has went through this can advise me on foods to eat, what kind of regime, excercise etc,I know its not going to be easy but this has went on since childhood, Im now 42 and been through all that these years of addiction entails.

  12. Hi peter,i could,nt advise against cold turkey from that amount of methadone enough,im sorry to say mate you will go through hell,especially the amount of time you bin using. i went through a high dose meth cold turkey last year and can definately say its harder than heroin to get off due to the long half life,i would advice titrating down over couple of mths dwn to around 10mls or preferably less. As for foods that will help you need a lot of vitamin c as it helps keep your immune system in check,potassium rich foods for the leg cramps such as bannanas/supplement or both,take these before the legs kick in to get the most out of them,plus B vitamins and magnesium aswell as magnesium (epsom salts) baths. As of writing i myself am not clean,im off the methadone but just starting a morphine cold turkey. i failed miserably with the methadone detox because of the dose i was on and duration of withdrawals,hopefully ill ave more success kickin the morphine. I see its a gd few mths since your post,how,d it go,if you still goin through the struggle good luck man,beat that evil affliction. I kno ive babbled on but has anyone any tips on how to flush the morphine out faster and reduce withdrawal time,thx4 any help,peace ppl and gd luck to all poor opiate addicted ppl they truly are the drugs of the devil

  13. Hi guys. I am serbian. I live in USA. Heroin and then Methadone + Heroin was my nightmare for 8 years. I tried cold turkey few times,3 rehabs in USA, 12step program. The longest pause was 6 weeks. All what is said here about Methadone I know from my own experience. I was so desperate to get rid of it and every next try it was tougher , it was getting from bad to worse. I was loosing belief in myself. In my home town Belgrade I found russian drug clinic Dr. Vorobiev. Some guys who had been treated there before advised me that. I went to their website and few day after I decided to take a chance one more time. I passed detox ( it took 2 special anesthesia assisted procedures in 5 days to be completely cleansed out Methadone) and got 3month Naltrexone implant at the end of the course. One year passed since . I upgraded the implant blockade 3 times. I cant say it was easy year. It was tough indeed. Now it is a bit easier. But I am still afraid of the idea to left without Naltrexone. Anyway so far so good.

  14. hey everyone,I just wanted to throw in something after reading all your valuable info,its the only thing keeping me sane.I am going through opiate and benzo withdrawals,an 8 year addiction,i quit cold turkey and wouldnt advise anyone to do this alone as i have,My thinking is distorted,i am thinking unrashingly,i am having severe panic attacks,i feel deathly sick and this is day 15,sorry had to stop and count,my heart is racing,just got some sleep last night after being up for two weeks,this is a living nightmare,but if anyone has any questions i would be glad to talk with you.

  15. Hey i want to quit xanax and i am taking one tablet of 0.5 mg everyday since last three years but from three days i am not taking xanax but i am havin withdrawals so can i wait for 2 more days without taking xanax how long does withdrawal lasts?

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