Is it dangerous to stop drinking suddenly?

Key takeaways

• Stopping suddenly after long-term heavy drinking can cause withdrawal that is painful or even life-threatening.
• Delirium tremens, a severe form of withdrawal, can cause confusion, hallucinations, fever and seizures.
• Past withdrawal seizures or delirium tremens, other medical conditions, age over 65 and benzodiazepine dependence raise the risk of severe withdrawal.
• Talk to a doctor before you stop: doctors can prescribe medication that makes withdrawal safer and less distressing.
• If you think you are in withdrawal after drinking often, contact a provider right away or go to an emergency room.

Why can stopping drinking suddenly be dangerous?

When someone who has been drinking heavily for a long time suddenly stops, the body can go into a withdrawal process that the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes as painful or even potentially life-threatening. MedlinePlus calls alcohol withdrawal a serious condition that may quickly become life-threatening, and the NHS says it can be very dangerous to stop drinking suddenly if you're dependent on alcohol.

That doesn't mean everyone who stops drinking is in danger. Most cases of alcohol withdrawal are mild and don't need medical treatment, but severe cases can lead to life-threatening complications. The more often you drink, the more likely you are to have withdrawal symptoms when you stop. That's why, for regular heavy drinkers, the safe first step is talking to a doctor rather than relying on willpower alone.

What are delirium tremens and alcohol withdrawal seizures?

Delirium tremens (often called DTs) is a severe form of alcohol withdrawal. MedlinePlus lists agitation and irritability, sudden severe confusion, fever, seeing or feeling things that aren't there, and seizures among its effects. A clinical review on the NIH's NCBI Bookshelf (StatPearls) gives these timings and figures:

• Withdrawal seizures typically happen 8 to 48 hours after the last drink.
• Delirium tremens can develop anywhere from 3 to 8 days after stopping.
• About 3% to 5% of people with alcohol withdrawal syndrome progress to delirium tremens, which can be fatal.
• Deaths from delirium tremens were historically as high as 20%; with modern critical care, prompt diagnosis and treatment, the rate is now around 1%.

Who is most at risk of severe alcohol withdrawal?

Risk rises the more often you drink, and MedlinePlus notes that withdrawal may be more severe if you have certain other medical problems. StatPearls names these risk factors for progressing to severe withdrawal:

• A history of withdrawal seizures or delirium tremens
• Other medical conditions
• Being over 65
• Physical dependence on benzodiazepines

Why does medical supervision matter?

Doctors can prescribe medications that make withdrawal safer and less distressing, according to NIAAA. Where withdrawal is managed depends on how severe it is. People with moderate-to-severe symptoms may need treatment in a hospital or other facility, where they are watched closely for signs of delirium tremens. People with mild-to-moderate symptoms can often be treated as outpatients, but MedlinePlus says they need someone to stay with them and will likely need daily visits to their provider until they are stable.

Repeated withdrawals also matter: successive withdrawal episodes tend to become more severe, especially in seizure risk. In the UK, NICE guidance says people in acute withdrawal who have, or are at high risk of, withdrawal seizures or delirium tremens should be offered hospital admission for medically assisted withdrawal.

When is alcohol withdrawal an emergency?

MedlinePlus advises contacting your provider right away, or going to the emergency room, if you think you might be in alcohol withdrawal, especially if you were drinking often and recently stopped. Most people who go through alcohol withdrawal make a full recovery, but death is possible, especially if delirium tremens occurs, so don't wait to see whether symptoms settle on their own.