“Just give it up cold turkey.” That is heard a lot from people when addicts are thinking about putting a stop to their drug abuse. The phrase “cold turkey” has been in our lexicon for numerous years and in basic terms, it means giving up a particular substance all at once. This method of detoxifying one’s body from substances has been used by people with a dependence on heroin, alcohol, benzodiazepines and other substances as a way of becoming sober, but it can cause immediate withdrawal symptoms and medical complications. Despite the intense and sometimes harmful effects of eliminating drugs or alcohol from the body in one go, many still think that this is the best way of becoming sober, and medical detox centres are seen as something only the very desperate should need. But what does cold turkey detox actually do to the body? This is not something most people think about when choosing home detox, but it is worth taking a look at if you or someone you know is thinking about heading down the road to recovery.
As stated above, cold turkey detox is the idea of stopping all alcohol or drug use at once. A lot of people think that this is the best method of detoxifying the body, as it eliminates the substance from the body quickly. This method of sudden and complete withdrawal is often used by nicotine addicts as well as those suffering from alcohol addiction. In fact, the Alcoholics Anonymous program makes complete elimination of alcohol from your system seem like the only method of detox. In the AA program, many believe that you cannot start counting your sobriety until you have completely stopped drinking, which for many newcomers to the program, means must quitting drinking cold turkey. There can be a lot of pressure to use this “all or nothing” attitude when it comes to eliminating harmful substances, and the general population does not really understand the risks associated with this detox method.
In fact, when it comes to the risks of complete withdrawal from drugs or alcohol with no medical intervention, the substance with the highest risk is actually alcohol. Rapid alcohol withdrawal can cause a syndrome called Delirium Tremens (DTs), which is extremely dangerous and can lead to death. The symptoms of Delirium Tremens are:
- Disorientation, delirium and confusion
- Profuse sweating
- Severe anxiety
- Low grade seizures
- High blood pressure
- Racing or irregular heartbeat
- Severe tremors
When detoxing from alcohol, it is important to know these physical and psychological symptoms before you start – if any of them appear after stopping alcohol use, the individual in withdrawal should be taken to the nearest hospital immediately.
The idea that withdrawing from alcohol can lead to such a serious condition is startling to many. In our society, alcohol is not portrayed as particularly harmful, and the idea that withdrawing from a substance that most adults use on a regular basis can be deadly, is very shocking. It is important to take the detox process seriously when deciding to become sober. Talking to a medical doctor can help the addict determine what precautions they might need to take in order to avoid such severe consequences.
Common drug withdrawal symptoms
All that being said, any withdrawal process can be very taxing to the body no matter what the substance. The common side effects of rapid detox from drugs/alcohol are:
- Nausea and vomiting
- Muscle aches
- Extreme cravings
Though these symptoms of withdrawal are less severe than those of Delirium Tremens, the process of detox can be very difficult to go through. When looking at the common side effects, we can see that it affects both our physical body and our mental state. When addicts stop using some prescription drugs, such as benzos or barbiturates, without medical care, there is a risk of them falling into psychosis and having suicidal urges. These consequences of rapid withdrawal from a drug point to the fact that quitting a substance “cold turkey” is not always healthy for the addict to do. Without medical supervision, abstaining from drugs or alcohol can have very serious consequences which the addict should know about before they decide to try becoming sober on their own.
Higher risk of relapse
It is also worth noting that when alcohol or drug addicts decide to withdraw from their substance of choice without the assistance of a medically supervised program, there is a very high risk of relapse. Though relapse is something no recovering addict is immune from, those who try to get clean on their own relapse at a rate of 80-90%. It is much more difficult for addicts to find success in sobriety if they have no outside help, as they need the support of others in order to stay on the path to recovery. Relapse can be dangerous for the addict, because the body will quickly lose tolerance for the substance of choice, and when the addict takes their usual dose of the drug or alcohol, there is a high risk of overdose. We see this a lot in the case of opioid addicts where the relapse rate is very high. When an opioid addict has rapid withdrawal from their drugs, their body quickly gets used to not having drugs in their system, which means that if they do relapse, the opioids will have a stronger effect, causing overdose and possibly, death. When looking at the opioid crisis in Canada and the United States, we can see how this cycle is a very common part of opiate addiction. The death rate due to opioid overdose is very high.
The safest way to withdraw from almost any type of drug is through medically supervised detox from the drug of choice. This lowers the rate of relapse, and the withdrawal process is much safer for the addict.
Medical detox refers to the process by which the body is cleared of toxic addictive substances under the supervision of medical professionals in a safe, comfortable environment. It is the safest way to go through this first step in the addiction recovery process.
The medical team usually consists of nurses and doctors who specialize in substance abuse, and it may also include therapists who are there to help deal with the psychological effects of withdrawal. Medical detox centres can run independently or in association with a hospital, or they can be attached to an inpatient or outpatient addiction treatment facility. The process of medical detoxification from drugs or alcohol will differ from person to person, but it usually lasts between five and seven days. Once the patient has the substance completely out of their system and they are considered stable, they will be discharged from the program, often leaving the addict to figure out what to do next. Medical detoxification programs should not be confused with addiction treatment since they only have one goal: helping the patient rid the substance from their system in a safe manner. That being said, most inpatient and outpatient detox centres will have information on hand for people looking for further treatment for their drug or alcohol abuse issues, and this can be a valuable resource for those looking for lasting sobriety.
An addict might choose medically supervised detox if they feel as though they have a physical dependence on the drug of choice. For example, if an alcoholic starts to experience physical withdrawal symptoms such as tremors or extreme discomfort after just a few hours without alcohol consumption, they would be wise to seek medical attention. An addict may have a physical dependency on drugs or alcohol if they have:
- Been using a substance regularly in large amounts
- Used a substance over an extended period of time
- Experienced a diminished effect over time from using the same amount of a substance
- Required increasing amounts of a substance to achieve the desired effect
- Craved a substance when access to it has not been possible
- Tried to quit using a substance and found that this was not possible without help
These factors are common to many addictions: this list can be a guide in helping one determine whether to seek medical help for a detox process. If there is any doubt, the individual should be taken to a doctor or hospital.
What happens at a detox facility?
Once the addict has decided to attend a medical detox facility, the basic process starts with an evaluation. The medical staff will take a detailed health history of the addict to ensure that there are no other conditions that could complicate the detox process, and also to determine the addict’s general health. Once this is known, the staff will question them about their drug or alcohol use. They will need to know exactly what substance was used, how often the addict used it and at what average dosage. They will use all of this data to create a treatment plan that is right for the individual. The idea behind medically supervised detox programs is that the addict is given progressively smaller doses of the substance to get it out of their body slowly. The process is monitored frequently to ensure that the side effects of withdrawal are not overwhelming to the individual. Once the patient’s body is completely free of the substance and their vital signs (blood pressure, heart rate, breathing rate) are stable, the process of detox is finished.
When the addict is approaching the end of a detox program, most facilities will provide them with recommendations on how to move forward. As stated above, medical detox is not the same as addiction treatment, since it does not treat any of the long- term effects of addiction. It is important for addicts to think about next steps once detox is over: without added help, relapse is likely. Some medical detox centres will have staff who can help the addict make these decisions, and this can help tremendously when someone is trying to become sober. The unfortunate fact, however, is that there is no guarantee of the addict accepting the help offered, which means that possible relapse is still a big concern for people who attend a detox facility. For programs that are publicly funded, there can be a large incidence of repeat patients, as these facilities tend to serve the most highly marginalized members of our society. Those unable to pay for a rehabilitation program after medically supervised detox is over may not have anywhere to go following the program, because most publicly funded rehabilitation programs have a waiting list. Unfortunately, this often falls on the shoulders of the homeless or those with precarious living conditions, and sobriety can be an unachievable goal if they are unable to get the help they need. Though medical detox facilities can play a vital role in addiction recovery, they really do only serve one purpose- eliminating toxic substances from a person’s body.
When deciding to become sober, it is important for the addict to understand what might happen to their body in the process. The withdrawal process can be very taxing on the body, and it can also effect the person’s mind. Though it might be appealing to not get medical help when deciding to eliminate toxins from the body, it could actually be quite dangerous to do so. Much of the population assumes that going “cold turkey” when becoming sober is the best way to tackle the addiction, but this approach can lead to death. A medically supervised detoxification program, however, provides a safe place for the addict to become clean, and it ensures that severe withdrawal symptoms are minimized. It is important to note, however, that both of these methods of detoxification do not automatically lead to long term sobriety. Both the “cold turkey” method and medical detox have high rates of relapse, and if an addict truly wants to become sober they must get further help once the detoxification process has finished. That being said, deciding to become sober is a very noble act for any addict, and it should be celebrated in our society rather than hidden. If there was less shame associated with being an addict, there might be less attraction to the “cold turkey” method of detoxification, as people would be less afraid of seeking medical help and going to an addiction treatment facility. And since we can see that sudden withdrawal of a toxic chemical from the body can have dire consequences, perhaps more work needs to be done on accepting addicts for what they are: human.
Photo credit: Mark Hillary. This picture has a Creative Commons attribution license.