Quitting alcohol cold turkey can be dangerous and even potentially fatal due to the risk of seizures associated with severe alcohol withdrawal. Doctors call significant alcohol withdrawal syndrome delirium tremens or DTs. [1] Up to 2% of people with DTs die due to the condition.[2]
Not everyone with alcohol use disorder will experience life-threatening withdrawal symptoms and many factors affect the severity and manifestation of withdrawal; however, it’s not worth the risk when professional care is available. Rather than quitting alcohol cold turkey, the safest option is to attend medical detox in a hospital or inpatient setting. Medications and monitoring can ensure you withdraw safely and transition into a comprehensive treatment program.
Is It Safe to Quit Alcohol Cold Turkey?
Quick Answer
No, if you have alcohol use disorder (AUD), it’s extremely dangerous to quit drinking alcohol on your own. This is because suddenly quitting can result in life-threatening withdrawal symptoms, such as seizures.
What Happens When You Quit Alcohol On Your Own?
If you are addicted to alcohol and try to quit cold turkey, you will experience uncomfortable or even dangerous alcohol withdrawal symptoms. These may include:[3]
- Anxiety
- Nausea and vomiting
- Insomnia
- Confusion
- Tremors
- Sweating
- Rapid pulse
- Irritability and restlessness
- Hallucinations
- Seizures
- Withdrawal delirium
Less than 25% of people with alcohol withdrawal develop severe symptoms like delirium and tremors, and only about 3% of people experience tonic-clonic seizures.[2,3] However, instead of taking the risk and detoxing at home, seek out an assessment through your doctor or at a medical detox facility where a team of professionals can evaluate your alcohol withdrawal risk.
Factors Affecting Alcohol Withdrawal
You may not experience all of the above withdrawal symptoms. Everyone’s withdrawal experience is different and can depend on many factors, including:
- Duration of alcohol use disorder
- Amount of alcohol regularly consumed
- Mental and physical health status
- Previous alcohol withdrawal experiences
- Genetics
- Individual physiology
- Polysubstance misuse
People who have previously tried to quit alcohol cold turkey and gone through alcohol withdrawal may be at an increased risk of serious withdrawal symptoms like seizures.
This is due to what’s known as “kindling” in which a person’s alcohol withdrawal symptoms worsen each time they attempt to quit drinking. Although the mechanism isn’t fully understood, it’s thought to be due to an increased sensitivity to stress as well as the fact that neural pathways have been primed.[4]
Kindling can not only increase the risk of death during withdrawal but it can also increase the risk of relapse in order to alleviate these unpleasant symptoms.[4]
Risk Factors for Life-Threatening Alcohol Withdrawal
Although many factors influence the severity of an individual’s alcohol withdrawal symptoms, there are some recognized risk factors for delirium tremens or withdrawal seizures, such as: [5],[6]
- Abnormal liver functioning
- Brain lesions
- Severe dehydration
- Electrolyte imbalances
- Co-occurring medical conditions
- Being older
- Drinking heavily every day
- History of withdrawal seizures or DTs
However, the severity and manifestation of alcohol withdrawal can be unpredictable, and doctors aren’t able to accurately predict which patients will and will not experience severe and dangerous symptoms. That’s why detoxing under 24/7 medical care is so essential.
Alcohol Withdrawal Timeline Without Medications
Alcohol is quickly metabolized, which means when you abruptly stop drinking on your own, you’ll likely experience withdrawal symptoms within four to 12 hours after your last drink.[5]
Alcohol withdrawal symptoms tend to peak in intensity during the second day and then start to resolve by day four or five.[5]
However, once acute withdrawal resolves, you may experience lingering symptoms known as protracted withdrawal for several months or even years. These symptoms may include: [5], [7]
- Insomnia
- Anxiety
- Autonomic dysfunction
- Sleep disturbances
- Problems thinking and concentrating
- Hostility
- Irritability
- Depression
- Mood swings
- Fatigue
- Unexplained physical pain
| Time Since Last Drink | Symptoms | Severity |
| 4-12 hours | Insomnia, headache, anxiety, nausea | Mild |
| 2 days | Hallucinations, seizures, tremors | Severe, symptoms peak |
| 4-5 days | Lingering anxiety and insomnia | Mild then resolve |
| Weeks to months | Anxiety, insomnia, depression, mood swings, irritability | Mild but may fluctuate |
Medical Detox for Alcohol Withdrawal
Instead of quitting alcohol on your own, you should seek out medical detox services. Even if your alcohol withdrawal syndrome isn’t potentially fatal, the Substance Abuse and Mental Health Services Administration (SAMHSA) still recommends 24-hour medical detox in an inpatient setting for alcohol withdrawal due to how distressing it can be. [8]
Medical detox can occur in several inpatient settings, such as: [8]
- Hospital
- Psychiatric hospital
- Freestanding inpatient detox center
- Inpatient detox facility within an addiction treatment program
During medical detox, you receive a variety of treatment modalities and interventions to help manage alcohol withdrawal, ensure your comfort and safety, address any complications, and help facilitate transition into alcohol addiction treatment.
Some interventions used in medical detox include:
- Alcohol withdrawal medications, such as benzodiazepines
- Supportive medical care, such as IV fluids and nutritional therapy
- Monitoring of vital signs
- Symptomatic medications
- Detox counseling
- Case management and wrap-around services
Medications for Alcohol Withdrawal
If you are going through detox in a medically supervised setting, you can be given medications that help ameliorate the unpleasant symptoms of alcohol withdrawal and prevent the more serious and potentially fatal side effects.
Generally, benzodiazepines are used as first-line treatment for alcohol withdrawal symptoms, with long-acting versions like diazepam or chlordiazepoxide being the preferred options.[8] Benzodiazepines, which have a similar mechanism of action to alcohol, can calm your overactive brain cells and relieve symptoms.
Benzodiazepines can be given in three ways in the hospital or detox center: [8]
- Fixed schedule: You take your medications on a routine that’s set by your doctor.
- Loading dose: In a hospital setting, the medical team will administer an intravenous or oral benzodiazepine frequently, such as every 1-2 hours until significant improvement.
- Symptom triggered: Your medical team assesses your withdrawal symptoms and offers treatment accordingly.
Once you are stabilized, the medical team will create a gradual tapering schedule in which your benzodiazepine dose is slowly reduced over time.
Sample Benzodiazepine Dosing Schedule for Alcohol Withdrawal Management [5]
| Benzodiazepine | Dose | Frequency |
| Chlordiazepoxide (Librium) | 50mg | Every 6 hours for 4 doses |
| 25mg | Every 6 hours for 8 doses | |
| Diazepam (Valium) | 10mg | Every 6 hours for 4 doses |
| 5mg | Every 6 hours for 8 doses | |
| Oxazepam | 30mg | Every 6 hours for 4 doses |
| 15mg | Every 6 hours for 8 doses | |
| Lorazepam (Ativan) | 2mg | Every 6 hours for 4 doses |
| 1mg | Every 6 hours for 8 doses |
If you have a history of complicated alcohol withdrawal—withdrawal with worrisome features such as seizures, hallucinations, or changes in blood pressure or heart rate—talk to your doctor about medically supervised withdrawal and the use of benzodiazepines to aid in your safety during detoxification.
Frequently Asked Questions About Quitting Alcohol Cold Turkey
Yes. Long-term drinking can suppress electrical impulses in your brain. When you suddenly quit, your brain cells can overreact and trigger symptoms, such as hallucinations, heart rate changes, and seizures. These can, in rare instances, be life-threatening. Shock is defined as changes in your vital signs, such as heart rate or blood pressure. In rare instances, individuals can go into shock and even die from alcohol withdrawal.
It really depends on the individual, your drinking habits, and your genetics. Some individuals can quit drinking “cold turkey” without any withdrawal symptoms, while others may have very severe or even life-threatening symptoms, such as hallucinations, seizures or shock that require intubation and intensive care. The greatest risk for developing these more serious symptoms is having a history of these withdrawal symptoms in the past. Everyone’s body is different when it comes to dependence on alcohol, and the amount of alcohol alone does not necessarily predict how severe withdrawal symptoms will be.
Yes, the acute symptoms of withdrawal usually last somewhere between one to five days. Once five days are over, generally, the symptoms of acute withdrawal subside and the risk of any dangerous withdrawal symptoms is minimal. However, you still may have cravings to drink and other post-acute withdrawal symptoms that can continue to last for weeks, months or even years after stopping drinking. In addition, though heavy drinking can cause many negative health effects, research shows that functional recovery is achievable. Even after chronic and heavy drinking, the liver has been shown to regenerate and heal to a certain degree.[9]
If you’ve been drinking heavily for a long time, you should not stop drinking suddenly without medical supervision. A medical professional can design and supervise a detox plan for you in which you receive alcohol withdrawal medications, 24/7 medical care and monitoring, and supportive medical care. That way, a treatment team is available around the clock to prevent and address any possible complications.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Delirium Tremens. National Library of Medicine. https://medlineplus.gov/ency/article/000766.htm. January 2021. Accessed May 2022.
- Risk Factors for Lethal Outcome in Patients with Delirium Tremens: Psychiatrist’s Perspective. A Nested Case-Control Study. Annals of General Psychiatry. https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/1744-859X-12-39. 2013. Accessed May 2022.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Becker HC. Kindling in alcohol withdrawal. Alcohol Health Res World. 1998;22(1):25-33.
- Bayard M, McIntyre J, Hill KR, Woodside J Jr. Alcohol withdrawal syndrome. Am Fam Physician. 2004;69(6):1443-1450.
- Sachdeva, A., Choudhary, M., & Chandra, M. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. Journal of clinical and diagnostic research. 2015; 9(9), VE01–VE07.
- Protracted Withdrawal. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf July 2010. Accessed June 2023.
- Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.
- Thomas, P.G., Rasineni, K. Saraswathi, V., Kharbanda, K.S., Clemens, D.L., Sweeney, S.A., et.al. Natural Recovery by the Liver and Other Organs After Chronic Alcohol Use. Alcohol Research Current Reviews. 2021; 41(18).
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