How medically dangerous is sudden drug withdrawal?

Factual Questions
1

Obviously different kinds of recreational drugs have different consequences when you suddenly are forced to stop using them but I’m curious about something. Under what circumstances would that sudden withdrawal be medically dangerous? What drugs or combinations thereof produce the most life threatening withdrawal symptoms? Assume that you have good nursing care keeping you clean, fed and hydrated but you can’t even get an aspirin for the pounding in your head.

I’m given to understand that barbiturate withdrawal can be spectacularly unpleasant.

FWIW, this thought was provoked by a bit of fiction I recently read where this kind of forced drug withdrawal was presented as a viable and legal means of police interrogation in post WWII Southern California.

2

Alcohol withdrawal can be deadly.

3

And what would the cause of death be? Heart failure? What specifically is happening in the alcoholic’s body as it struggles with withdrawal?

4

Benzodiazepine withdrawal can also cause death.

5

You get tapered off drugs such as Beta Blockers. I have learnt that to my dismay. Still produces less than pleasant symptoms.

6

Alcoholic Withdrawal Syndrome - there are a number of mechanisms that may cause death - brain damage, central nervous system disruption, heart failure. Long term alcohol use produces changes to cellular function in the central nervous system - these changes mean that cells start to malfunction without alcohol. This widespread disruption to the cns will kill you.

Si

7

The list of commonly abused drugs that can also have death as a statistically significant risk factor during withdrawal is pretty small. Alcohol, barbiturates, and benzodiazapines are the main ones and they are all related in their mechanism of action of the problems that result from a ‘cold turkey’ withdrawal. The nervous system becomes habituated to their chronic depressive effect and learns to compensate for it. When the drug is taken away, it rebounds and that can cause everything from seizures, to extreme mental disorientation and hallucinations, to cardiac arrest.

‘Uppers’, even crystal met and crack, don’t usually cause death from withdrawal. Opiate withdrawal (heroine, oxycontin etc.) is ugly and extremely uncomfortable but generally won’t kill the person either. The list is rather exclusive to those in the first paragraph.

8

Not “usually” perhaps, but still not a pleasant stroll down a country lane.

If we want to expand the definition to include death or injury from causes that are not strictly medical in nature, one may wish to consider things such as SSRI discontinuation syndrome.

9

Cops even now know that while no one enjoys a spurious arrest, opiate addicts REALLY don’t enjoy spurious arrest.

There was even a episode of COPS where an officer was harassing a addict that had nothing on him really with arrest for loitering in a drug area or something, the threat of forced withdrawal in jail was obviously implied.

10

In addition to those already mentioned (benzodiazepines, barbiturates, beta blockers), here are a few other drug types where sudden discontinuation can lead to life-threatening withdrawal syndromes:

clonidine
glucocorticoids (such as prednisone and many others)
L-dopa (cite)

I have a feeling that I am forgetting some . . .

As an aside, to the best of my knowledge, SSRI and SNRI withdrawal syndromes can be distressing but are not life-threatening.

11

True. That’s why my statement was qualified and I provided a link.

12

I thought it also depends on dosage and duration of use. My sister used Inderal 10mg once a day for about 3 months (for migraines) and the doctor told her she did not need to taper off and could discontinue them.