# Why Do people Undergoing Alcohol Withdrawal Report Hallucinations? **URL:** \ **Category:** Factual Questions\ **Created:** [September 5, 2013, 12:58pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070 "2013-09-05T12:58:44Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![ralph124c](https://avatars.discourse-cdn.com/v4/letter/r/8797f3/32.png) [@ralph124c](https://boards.straightdope.com/u/ralph124c)\ **Post date:** [September 5, 2013, 12:58pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/1 "2013-09-05T12:58:44Z")
Popular folklore says that people experiencing alcohol withdrawal (“delirium tremens” see pink elephants, other weird, impossible animals. many also report feeling insects crawling on their skin-the sensations are said to be very terrifying. Are these reports true? Evidently their brains are reporting sensations that are not there-are these symptoms unique to alcohol addiction? ---
**Author:** ![njtt](https://avatars.discourse-cdn.com/v4/letter/n/ecd19e/32.png) [@njtt](https://boards.straightdope.com/u/njtt)\ **Post date:** [September 5, 2013, 2:52pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/2 "2013-09-05T14:52:21Z")
Hallucinations are caused by malfunctions of the brain. Alcohol is a drug that causes the brain to malfunction. Why would you find it surprising that it can cause hallucinations? If you want an account of why it causes the particular sorts of hallucinations that it does, or why they mainly occur in the aftermath of major alcohol poisoning, well, I don’t know, but I should imagine that any satisfactory explanation, if known at all, would be lengthy and technical. ---
**Author:** ![Si\_Amigo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/si_amigo/32/2877_2.png) [@Si\_Amigo](https://boards.straightdope.com/u/Si_Amigo)\ **Post date:** [September 5, 2013, 3:00pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/3 "2013-09-05T15:00:21Z")
> [@ralph124c](#): > > are these symptoms unique to alcohol addiction? No, people withdrawing from narcotics also have these same symptoms and they both need to be carefully monitored or they could literally die from their withdraw. ---
**Author:** ![Lumpy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lumpy/32/446_2.png) [@Lumpy](https://boards.straightdope.com/u/Lumpy)\ **Post date:** [September 5, 2013, 4:01pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/4 "2013-09-05T16:01:36Z")
Alcohol is a depressant; once someone becomes habituated to it and then has it cut off, the brain reacts in a way similar to an overdose of amphetamine. That’s why barbiturates are used to control DTs- they’re a substitute depressant. ---
**Author:** ![Xema](https://avatars.discourse-cdn.com/v4/letter/x/9de053/32.png) [@Xema](https://boards.straightdope.com/u/Xema)\ **Post date:** [September 5, 2013, 9:12pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/5 "2013-09-05T21:12:56Z")
> [@njtt](#): > > Why would you find it surprising that it can cause hallucinations? The OP is not professing surprise that alcohol causes hallucinations, but rather that its withdrawal does. Lumpy has supplied a very plausible explanation as to why this could happen. ---
**Author:** ![Schism](https://avatars.discourse-cdn.com/v4/letter/s/97f17d/32.png) [@Schism](https://boards.straightdope.com/u/Schism)\ **Post date:** [September 5, 2013, 10:09pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/6 "2013-09-05T22:09:33Z")
People rarely die from narcotic withdrawal. You’ll want to die and you’ll feel like you’re gonna die but you probably won’t. I think benzodiazepine withdrawal can be fatal, but overall alcohol withdrawal is more dangerous. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [September 6, 2013, 12:16am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/7 "2013-09-06T00:16:14Z")
Benzo and alcohol withdrawal are potentially dangerous and can cause (in addition to hallucinations) seizures or death. As noted, withdrawal from narcotics/opioids might make you feel so awful you think you’re dying, but you’re not. Death from narcotic withdrawal is almost unknown and I suspect is only found in people with prior very serious health conditions. In other words, cutting off alcohol cold turkey is far more dangerous than kicking heroin. ---
**Author:** ![Gagundathar](https://avatars.discourse-cdn.com/v4/letter/g/a183cd/32.png) [@Gagundathar](https://boards.straightdope.com/u/Gagundathar)\ **Post date:** [September 6, 2013, 12:33am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/8 "2013-09-06T00:33:11Z")
I have heard the same as **Broomstick**. Alcohol withdrawal is a genuinely dangerous process when the person has been a long-term user. Death is not rare from unmonitored cold-turkey alcohol withdrawal. Benzodiazepine withdrawal is almost as dangerous, but it is easier to step down from them by gradually reducing the dosage. Alcohol is more difficult to titrate diminishing dosages this is according to my large and well-paid medical staff who live here with me in my vast and secret underground lair. ---
**Author:** ![sangfroid](https://avatars.discourse-cdn.com/v4/letter/s/e0b2c6/32.png) [@sangfroid](https://boards.straightdope.com/u/sangfroid)\ **Post date:** [September 6, 2013, 3:42am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/9 "2013-09-06T03:42:22Z")
> [@Gagundathar](#): > > I have heard the same as **Broomstick**. Alcohol withdrawal is a genuinely dangerous process when the person has been a long-term user. Death is not rare from unmonitored cold-turkey alcohol withdrawal. Benzodiazepine withdrawal is almost as dangerous, but it is easier to step down from them by gradually reducing the dosage. Alcohol is more difficult to titrate diminishing dosages this is according to my large and well-paid medical staff who live here with me in my vast and secret underground lair. I have heard/read this also, and would like to hear from someone on the board qualified to repond. **QTM** , maybe? What, exactly, is it about alcohol that makes it so dangerous for a long term user to just quit? It is a very common substance that is routinely abused. Why shouldn’t someone just “up and quit” after long term use? Isn’t that precisely what the medical profession advises? Stop using/abusing? Or does it truly \*have \*to be done under medical supervision? Resources are limited for inpatient care facilities in most places. What other options are there for people wanting to quit? Seems like a bit of a catch-22. ---
**Author:** ![Truman\_Burbank](https://avatars.discourse-cdn.com/v4/letter/t/ecc23a/32.png) [@Truman\_Burbank](https://boards.straightdope.com/u/Truman_Burbank)\ **Post date:** [September 6, 2013, 3:48am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/10 "2013-09-06T03:48:59Z")
I am not a neuropsychologist, but my understanding is that you want to combine what **Lumpy** said, that alcohol is a _depressant_, and recall from Biology class that the human body is constantly striving to maintain _homeostasis_. When your brain has become habituated to the depressant effect, and worked hard to counteract it to maintain homeostasis (which is why alcoholics can tolerate more booze than sober people), and then you suddenly withdraw the alcohol, the neurons start to fire like crazy. This can lead to seizures and hallucinations, which is basically sensory neurons being way too sensitive and firing en masse even in the absence of stimuli. More or less. There are a lot of different approaches to detox, medically it might well be feasable to detox someone on an outpt basis, the main problems would be the need for consistent monitoring of the pt’s condition, and the risk they might relapse and combine their alcohol with the detox meds, which can be very dangerous indeed due to the phenomenon of _potentiation_ (ie, the two drugs combined have a multiplicative, not just additive, effect) ---
**Author:** ![Ranger\_Jeff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ranger_jeff/32/2065_2.png) [@Ranger\_Jeff](https://boards.straightdope.com/u/Ranger_Jeff)\ **Post date:** [September 6, 2013, 3:58am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/11 "2013-09-06T03:58:57Z")
> [@ralph124c](#): > > Popular folklore says that people experiencing alcohol withdrawal … \ … report feeling insects crawling on their skin-the sensations are said to be very terrifying. > Are these reports true? Evidently their brains are reporting sensations that are not there-are these symptoms unique to alcohol addiction? This symptom can also occur with heroin withdrawal. Both alcohol and opiates can deaden your sense of touch, especially when used over a long period of time. During detox, especially cold turkey (non-physician supervised), as the system flushes out the drugs the numbness that addicts aren’t even aware of any more lessens and they begin to feel. Insects aren’t crawling over them, but the brain is now receiving and/or processing signals from nerves that it hasn’t for a while. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 6, 2013, 6:31am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/12 "2013-09-06T06:31:03Z")
I did cold turkey alcohol withdrawal (in hospital). They used a benzo (Ativan, IIRC) to control the edginess. This was 5-6 years ago. I had been using benzo sleepers for several years. Very few actually could put me down - I have incredible tolerance for all CNS depressants. Between the search for a working sleeper and withdrawal, I have gone through most of the benzos. One piece of advice: Triazolam is a very effective, fast-acting, quick-burn-off sleeper. It also causes brain damage and death if used for prolonged periods. My doc had me taking 1.5x max dosage for 2-3 years. ---
**Author:** ![guizot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guizot/32/3636_2.png) [@guizot](https://boards.straightdope.com/u/guizot)\ **Post date:** [September 6, 2013, 6:55am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/13 "2013-09-06T06:55:10Z")
> [@sangfroid](#): > > What, exactly, is it about alcohol that makes it so dangerous for a long term user to just quit? It is a very common substance that is routinely abused. Why shouldn’t someone just “up and quit” after long term use? I don’t know exactly, but alcohol is different in many ways from the other drugs where they tell someone to “up and quit.” I think the fact that it is such a common (and natural) chemical might have something to do with it. > [@usedtobe](#): > > I did cold turkey alcohol withdrawal (in hospital). > They used a benzo (Ativan, IIRC) to control the edginess. I think they give you benzos for more than “edginess.” They give someone benzos when he or she cuts off alcohol so the process doesn’t kill them, by way of a seizure, for example. It suppresses the nervous system in the same way, but can be titrated more precisely and in a controlled manner. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [September 6, 2013, 8:35am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/14 "2013-09-06T08:35:28Z")
> [@sangfroid](#): > > I have heard/read this also, and would like to hear from someone on the board qualified to repond. **QTM** , maybe? QtM has said the same thing in other threads, and maybe he’ll drop by in this one. He also has first-hand experience with narcotic withdrawal so he knows a bit about that, too. > [@](#): > > What, exactly, is it about alcohol that makes it so dangerous for a long term user to just quit? It is a very common substance that is routinely abused. Why shouldn’t someone just “up and quit” after long term use? When you quit alcohol and the nervous system is no longer depressed it can become overactive and go haywire, resulting in tremors, seizures, and other very unpleasant things. > [@](#): > > Isn’t that precisely what the medical profession advises? Stop using/abusing? Yes, but suddenly stopping is NOT advised if it will put your life at risk. Alcohol isn’t the only drug where people are advised to detox _slowly_ rather than just quit abruptly. > [@](#): > > Or does it truly \*have \*to be done under medical supervision? Resources are limited for inpatient care facilities in most places. What other options are there for people wanting to quit? Well, in theory you _could_ do it at home taking judicious sips of alcohol now and then, enough to prevent seizures and death but without taking so much you prolong the addiction but that’s _really_ hard to do - I mean, c’mon, if a person could do that, control their alcohol consumption, they wouldn’t be an addict, right? Outside of the medical setting death rates from abrupt alcohol withdrawal are reported between 25-35% depending on the source you use. You don’t _have to_ detox from alcohol abuse in a medical ward, but it’s a hell of a lot safer, the death rate these days is more like 5% if you’re under a doctor’s care. ---
**Author:** ![si\_blakely](https://avatars.discourse-cdn.com/v4/letter/s/d9b06d/32.png) [@si\_blakely](https://boards.straightdope.com/u/si_blakely)\ **Post date:** [September 6, 2013, 9:05am UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/15 "2013-09-06T09:05:28Z")
Alcohol and Benzodiazepines influence the [GABAergic](http://en.wikipedia.org/wiki/GABA)system - the chief inhibitory neurotransmitter in the CNS. Natural management of this system is suppressed by the constant application of an artificial supply (alcohol and benzo). The CNS takes longer to recover functionality than the lifetime of the drugs in the system, and takes even longer the more episodes of withdrawal experienced (kindling - the withdrawal gets worse on subsequent episodes). The CNS becomes hyperactivated without GABA inhibition (natural or artifical), causing the dangerous side-effects that lead to risk of death (and hallucinations, etc). [Alcohol Withdrawal Syndrome](http://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome). ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 6, 2013, 1:28pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/16 "2013-09-06T13:28:48Z")
What **Broomie** and others have said. ---
**Author:** ![joemama24\_98](https://avatars.discourse-cdn.com/v4/letter/j/ce7236/32.png) [@joemama24\_98](https://boards.straightdope.com/u/joemama24_98)\ **Post date:** [September 6, 2013, 2:14pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/17 "2013-09-06T14:14:08Z")
Does anyone know what the general level of alcohol consumption must be in order for these risks to manifest with withdrawal? I used to drink perhaps a pint a night (vodka) for several years while in college, though I would occassionally stop for 2-4 days, sometimes a week. I don’t recall any adverse effects when stopping (in fact I remember sleeping much better, and feeling better), but I never stopped for very long. I still drink habitually…for perhaps a decade after college 1-2 beers a night with the occasional binge, and for the past few years sometimes 3-4/night. Again, I occassionally go for a few days without, but this has me a bit concerned about stopping altogether, which I’ve come to realize may be the only option for me to lead a healthier lifestyle. ---
**Author:** ![Speaker\_for\_the\_Dead](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@Speaker\_for\_the\_Dead](https://boards.straightdope.com/u/Speaker_for_the_Dead)\ **Post date:** [September 6, 2013, 3:10pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/18 "2013-09-06T15:10:07Z")
> [@joemama24\_98](#): > > Does anyone know what the general level of alcohol consumption must be in order for these risks to manifest with withdrawal? I used to drink perhaps a pint a night (vodka) for several years while in college, though I would occassionally stop for 2-4 days, sometimes a week. I don’t recall any adverse effects when stopping (in fact I remember sleeping much better, and feeling better), but I never stopped for very long. I still drink habitually…for perhaps a decade after college 1-2 beers a night with the occasional binge, and for the past few years sometimes 3-4/night. Again, I occassionally go for a few days without, but this has me a bit concerned about stopping altogether, which I’ve come to realize may be the only option for me to lead a healthier lifestyle. I’m impressed you had no withdrawal symptoms after drinking 16 ounces of hard liquor a day. But quitting from 3 drinks/day isn’t dangerous for most people. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 6, 2013, 3:44pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/19 "2013-09-06T15:44:45Z")
> [@joemama24\_98](#): > > Does anyone know what the general level of alcohol consumption must be in order for these risks to manifest with withdrawal? It depends on a lot of factors. Liver health, genetics, size, weight, protein levels, fat composition, metabolism, gender, drinking history, and probably even phase of the moon. But to summarize alcohol dependence and withdrawal, about 8 million people in the US are alcohol dependent; that is they’ll have physical withdrawal symptoms if they stop drinking. There are about half a million cases of alcohol withdrawal seen each year which are severe enough to need pharmacologic intervention, and about 5% of those have DTs as a result. The mortality rate for DTs is about 5% also. The mortality rate before the widespread use of benzos to detox was about 40-40%. ---
**Author:** ![Truman\_Burbank](https://avatars.discourse-cdn.com/v4/letter/t/ecc23a/32.png) [@Truman\_Burbank](https://boards.straightdope.com/u/Truman_Burbank)\ **Post date:** [September 6, 2013, 4:21pm UTC](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070/20 "2013-09-06T16:21:35Z")
> [@joemama24\_98](#): > > Does anyone know what the general level of alcohol consumption must be in order for these risks to manifest with withdrawal? I used to drink perhaps a pint a night (vodka) for several years while in college, though I would occassionally stop for 2-4 days, sometimes a week. I don’t recall any adverse effects when stopping (in fact I remember sleeping much better, and feeling better), but I never stopped for very long. I still drink habitually…for perhaps a decade after college 1-2 beers a night with the occasional binge, and for the past few years sometimes 3-4/night. Again, I occassionally go for a few days without, but this has me a bit concerned about stopping altogether, which I’ve come to realize may be the only option for me to lead a healthier lifestyle. If you are not experiencing any discomfort on the occasions you go several days without alcohol, I’d guess you’re unlikely to have serious medical issues with sobriety, but I am not an MD. If you have benefits, you might want to have a heart-to-heart with your MD before you abstain all together. And, of course, if you want to tap into the expertise of many people who have quit drinking, there is no doubt an AA meeting nearby. Good luck. [Next page](https://boards.straightdope.com/t/why-do-people-undergoing-alcohol-withdrawal-report-hallucinations/668070.md?page=2)