Amy Winehouse death due alcohol withdrawal syndrome?

[Rhythmdvl]

While Pigpen’s alcoholism may have played a small role in his death, there was another, overriding factor: He played keyboards for the Dead.

[voltaire]

@The_Man_In_Black

Maybe it’s just in my state, but isn;t it illegal to have opened containers of alcohol in a car?

It’s not illegal in the back of a limo or other professionally chauffeured vehicle.

@Broomstick

…I have to say that the physical size of the person has little do with it - they make it sound like her petit size made her more vulnerable. I doubt it. Big, strapping, tall men have died of this, too.

I don’t think it had anything to do with her normal size or stature, but I think she was looking a bit emaciated towards the end there, so the health effects of that couldn’t have helped.

@KarlGauss

The way you paraphrase your cite is somewhat misleading.

Yes, “they may occur up to 7 - 10 days after the last drink”, but that isn’t the same as saying they can start at such a late date.

Beyond that, though, to say that the “DTs . . . can last weeks” has a very different implication than what the cite said. Specifically, your link stated only that the three non-life-threatening symptoms of “emotional mood swings”, “feeling tired”, and “sleeplessness” may last a year or more.

The potentially lethal manifestations of the DTs are not a threat after a week to ten days since the onset of the condition.

As I surmised upthread, it wouldn’t be surprising if she were using benzos, and withdrawal from those can cause DT, as well.

[psychobunny]

@KarlGauss

The way you paraphrase your cite is somewhat misleading.

Yes, “they may occur up to 7 - 10 days after the last drink”, but that isn’t the same as saying they can start at such a late date.

Beyond that, though, to say that the “DTs . . . can last weeks” has a very different implication than what the cite said. Specifically, your link stated only that the three non-life-threatening symptoms of “emotional mood swings”, “feeling tired”, and “sleeplessness” may last a year or more.

The potentially lethal manifestations of the DTs are not a threat after a week to ten days since the onset of the condition.

I agree that my cite is confusing. I interpret it as while Delirium tremens usually begins within 3 days it may begin as late as 7-10 days after withdrawal-at least that is what I was taught in medical school. Regardless, there is evidence that the acute delirium can certainly last 10 days after onset, meaning that many patients are not clear until two weeks after stopping drinking. As you noted, the psychological effects can last longer, but I am more concerned with symptoms like seizures, or delirium which can lead to aspiration and death. I agree that there are only case reports of severe symptoms lasting more than 2-3 weeks but they do exist. In this metaanalysis of treatment protocols, most elected to treat for minimum 10 days and up to 3 1/2 weeks.
http://www.csam-asam.org/pdf/misc/delirium_guidelines_ARCH_IM.pdf

[psychobunny]

Sorry-I can’t divide any more. In the article I cited, the treatment was for 3-5 days. In short, though, I do agree that symptoms rarely last more than 10 days but there are some cases of more prolonged symptoms. I’ll just back slowly out of this thread now and go back to studying for my recertification (which I very clearly need to do).

[njtt]

@Rhythmdvl

While Pigpen’s alcoholism may have played a small role in his death, there was another, overriding factor: He played keyboards for the Dead.

Well, if you are suggesting that there is some sort of jinx on the keyboard position in the band, it began with Pigpen. Anyway, AFAIK Tom Constanten and Bruce Hornsby are both still alive.

[WhyNot]

@njtt

I think TruCelt is probably thinking of Ron “Pigpen” McKernan, who was indeed a founder member and sometimes lead singer of the Grateful Dead (most of the band sang lead on occasion, but Pigpen, unlike the others, was much more notable as a singer than as an instrumentalist). Unlike the rest of the band, Pigpen’s drug of choice was alcohol, and it almost certainly was a principal cause of his early death, which occurred in 1973, about two decades before Jerry Garcia died (having, himself, long indulged heavily in rather more illegal substances). I don’t think Pigpen died from alcohol withdrawal, per se, however, just run-of-the-mill cirrhosis and its complications.

(I have never heard that Jerry’s Death was caused specifically by withdrawal, either.)

According to wikipedia (which, forgive me, is all I have to go on; he died a year before I was born) he died of a GI bleed. That could have been related to his congenital biliary cirrhosis - which is a genetic autoimmune disorder, made worse by, but not caused directly by, alcohol consumption. It’s also, we now think, possibly made worse by gluten consumption, so he may have been done in by bread, not booze!

[MPB_in_Salt_Lake]

@njtt

Well, if you are suggesting that there is some sort of jinx on the keyboard position in the band, it began with Pigpen. Anyway, AFAIK Tom Constanten and Bruce Hornsby are both still alive.

I have met Bruce Hornsby (briefly) and he seemed like a really nice guy, but TC is a dyed-in-the wool, Grade A asshole, who still eeks out a living playing Grateful Dead music to half-empty barrooms filled with a few Lost Sailors and assorted Wharf Rats, but seems to think he is some sort of Creative Musical Genius.

Even his old friend Phil Lesh doesn’t want anything to do with him and his oversized ego…

(I seem to recall that not too long ago, some Doper mentioned that he met or even kind of knew Bruce Hornsby, and said he was an egotistical prick, but that wasn’t my experience at all, though I only talked to him for a few short minutes)

[yabob]

In addition to not dying of heart failure, Pigpen didn’t die while in a rehab facility, which TruCelt referred to. Jerry Garcia did. And Brent Mydland overdosed on a speedball.

[TruCelt]

I was thinking of Garcia, and I understood that he died in the first few days of withdrawal, (asleep or passed out) and that he had been using alcohol for several weeks to try to wean off of drugs. I also understood that he was unsupervised in a pseudo-rehab, which is just inappropriate for a heavy user of anything at all.

Can’t speak for the source all these years later, but the timing would seem to indicate a strong role for withdrawal in his death.

[Omar_Little]

Toxicology reports are now in and Winehouse had no illegal drugs in her system at her time of death.

[Sateryn76]

@Omar_Little

Toxicology reports are now in and Winehouse had no illegal drugs in her system at her time of death.

I’m really surprised by this. If it was because of alcohol withdrawal, then…just wow…how sad…

ETA: Just noting that the results were announced by the family - and no “illegal” substances were found. Does that not include alcohol and prescribed meds?

[yabob]

They apparently found some alcohol in her system, they haven’t said how much, and it’s not known if it had any role in her death.

[irishgirl]

If a dependent drinker (i.e. someone who gets shaky without a drink) comes to see me saying they want to stop alcohol I go through a little string of questions to find out if they are suitable for Home Detox.

In essence, Home Detox involves a carer (friend/family member/responsible adult other than the patient) dispensing a medication like Librium for 3-5 days to prevent DTs, nurses calling to the house daily to check pulse rate and blood pressure, and lots of advice to call 999 if things go pear shaped.

People are not suitable for home detox if:

• they have no responsible person to control their Librium and stay with them while they withdraw
• they have ever had a previous episode of DTs or a withdrawal seizure
• they will not agree to monitoring of BP at home
• the have some underlying health conditions
• I can’t trust them or their carer to be sensible about when to seek help should things go wrong (this is a big one).
• they’ve had 2 or more failed Home Detoxes in the last year.

The choices if they are not suitable for planned home detox is either a detox in hospital or to keep drinking. An unsupervised, unmedicated cold turkey detox is simply not a safe option.

We do a lot of Home Detox.

I have had patients who go into withdrawals if they go longer than 4 hours without a drink- they don’t just have “eye openers”, they wake in the middle of the night sweaty, shaky and with palpitations, and have to drink.

Those guys- well, they’re going straight to hospital, should they ever decide to stop drinking.

I hated the first week of Lent with a passion when I worked in hospitals. This is Ireland- the land of hard drinking and heavy-duty religious guilt. Not a great combo, as it turns out.

About 2 or 3 days into Lent we’d suddenly start getting people who were in denial about their level of physical dependence on alcohol arriving at the emergency room sweaty, shaky and very unwell. They had decided to give up drink for Lent, just to see if they could, and found out that really, they couldn’t.

Full on withdrawal seizures or an agitated, delirious, hallucinating person with a pulse rate through the roof are so not fun to deal with.
Dealing with several of them at a time- even less so.

If you have an alcoholic in your life that you love, never, ever allow them to detox without proper medical supervision and advice, and make sure that they plan any detoxes. It should never be an impulsive decision to stop drinking, but rather a planned process with a lot of safety nets in place.

[Omar_Little]

Well all that speculation was wrong.

Investigating coroner finally released his report and Ms. Winehouse died of alcohol poisoning. She had roughly 5x the legal driving limit in her bloodstream. They apparently found 3 empty fifths of vodka in her closet.