Why do drug users go cold turkey to get off of a drug habbit instead of reducing exposure to the drug over a number of weeks or months until stopping using the drug alltogether. I assume going cold turkey would be the fastest way off of a drug, but aren’t the side effects caused by stoping use much worse for someone going cold turkey?
Is it safer medically to go cold turkey than to gradually reduce doses for some addictive drugs?
I think that the reason many people go cold turkey is because they are less likely to fall back into old behaviors. If you still allow yourself to indulge its sometimes too easy to pick the habit right back up. Out of sight, out of mind.
It depends on the drug. As bongmaster pointed out, going cold turkey can help avoid sliding back into drug use. Nicotine is a good example that I know about from personal experience. 
I believe opiates such as heroin or morphine are another group that is easy to slide back into heavy use if a gradual withdrawal is tried.
OTOH, some drugs like Valium shouldn’t be dropped cold turkey as the withdrawal symptoms can be lethal. I believe there are several like this.
Regards
Testy
Very true. Gradual withdrawal needs to be monitored. Most addicts who try this just end up continuing to use.
The benzos like Valium, Xanax, etc. are almost never fatal. They can rarely cause seizures during withdrawal, which themselves are rarely fatal. So it’s a stretch to day that benzo withdrawal can be fatal. Not impossible, but not likely.
OTOH, abrupt withdrawal from barbiturates and from alcohol can be fatal.
QtM, MD
QtM Abrupt withdrawl from barbiturates and from alcohol can be fatal :eek:
I had never heard of this, what level of alcohol consumption is high enough that going cold turkey could be lethal? and what is the cause of death in such fatalities?
I see you say gradual withdrawl has a high failure rate. Would you say it was more difficult to do than going cold turkey for an addict, or is it that an addict who tries gradual withdrawl, has to keep in touch with drug suppliers and so is more open to ‘temptation’ to stop trying to quit?
The usual cause of death during alcohol withdrawal is caused by
delirium tremens (read the symtoms here). . Generally, the people who suffer delirium tremens are late-stage alcoholics who have been drinking continually for a very long duration (many days, weeks, or years) and have done much physical damage to their body although occasionally someone without such a long history will suffer from them. The fatality rate for those who enter into delerium tremens is estimated to be 35% in the linked article but I have heard higher and lower figure elsewhere.
If you go to an emergency room and tell them that you are suffering from alcohol withdrawal, you will be immediately sent to the nearest detox unit (by ambulance if neccessary) because of the risk (I know this from experience).
Delirium Tremens
Only 5% of those who have alcohol withdrawal have DTs. But if untreated, over a third of people with DTs die of them. With treatment, only 5% die.
Gradual withdrawal is sort of like “hanging someone slowly”. And if the addict’s supply is not under external control, he’ll just tend to take more, to reduce the discomfort, and plan on quitting for real “tomorrow”.
To answer your first question, withdrawal from some substances such as alcohol, heroin, oxycontin, benzos, and barbituates are treated with tapering doses of other drugs.
Alcohol and barbituate withdrawal is treated with benzos such as Librium, Ativan, and sometimes Valium. Heroin and oxycontin withdrawal is sometimes treated with methadone in the short term or through daily long-term maintenance doses. These treatments are usually done in a dedicated detox ward or in a pyschiatric ward.
Note that withdrawal from stimulants such as cocaine (in powder or crack form), amphetamines etc. are not usually treated at all medically because there is little risk of death or trauma from their withdrawal.
I drank beer to excess for better than 10 years. Every day. Even I was calling myself an alcholic.
I was just recently diagnosed as a diabetic. I quit drinking cold 3 weeks ago. Since then nothing. No DT’s, no cravings, I sleep well. Except for the getting up to urinate 4-5 times a night. Hey it used to be 8-10 times so it’s getting better.
So what makes a drinker an alcoholic?
Damn…my post above was supposed to be a new thread…forgive me.
It’s really easy to talk myself into another cookie after I have the first one.
I hope you’ve had your blood glucose checked recently. Getting up that often to pee is not uncommonly either prostate trouble or diabetes.
Just so’s ya know.
And an alcoholic is one who continues drinking alcohol despite serious negative consequences which result from said drinking alcohol. Like getting one’s 3rd DUI.
BTW, in the US in this day and age, get one DUI and your risk of being an alcoholic is only slightly more than average (call it 12%). Get two, and it rises to over 75%. But get three, and your risk of being an alcoholic is over 95%.
A lot of the opioid users I’ve interviewed who have gone on gradual tapering detox[sup]1[/sup] have said that once the daily dosage level falls below a certain level – usually somewhere between 7mg and 20mg – it’s just like going cold turkey. Personally, I would have to assume that it can’t be as bad as going cold turkey on a full dose (which is usually anywhere from 60-100mg per day and sometimes higher), but most of them say it is. I can’t find my notes to put together an exact percentage at the moment, but from memory I think at least half of them abandoned their plans to taper off completely and went back up to an effective daily maintenance dose.
Little risk of death … except perhaps an elevated risk of suicide, since withdrawal from heavy use of stimulants like cocaine/amphetamines produces symptoms almost identical to major depression. But I’m just guessing – I haven’t seen any studies on whether the incidence of suicide actually is higher among people who abruptly stop using powerful stimulants.
[sup]1[/sup]Almost all of whom were doing so under controlled conditions at a methadone clinic – I’ve only ever met two people who had tried doing so on their own, and neither of them succeeded in tapering off to zero.