Can alcohol withdrawal be fatal?

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Alcohol withdrawal exists within the context of long-term alcohol dependence. It occurs when someone with an AUD stops drinking entirely or significantly reduces their alcohol intake.

The body can react to this sudden change in a number of ways.

According to a 2022 review of scientific literature, alcohol withdrawal can be fatal.

Learn more

Learn more about alcohol use disorder and alcohol withdrawal.

• How can you help a person with alcohol use disorder?
• Signs of alcohol withdrawal syndrome
• What is the timeline for alcohol withdrawal symptoms?

As the 2022 review above explains, there are many symptoms of alcohol withdrawal. These can unfold over several hours or days.

Initially, alcohol withdrawal can cause relatively minor issues. These can develop within 6 hours of the change in alcohol consumption. Such symptoms include:

• high blood pressure
• insomnia
• tremors
• overactive bodily reflexes (hyperreflexia)
• anxiety
• upset stomach
• headache
• heart palpitations

These symptoms can sometimes progress to more serious issues, such as hallucinations and alcohol withdrawal seizures.

However, the most serious form of alcohol withdrawal is a condition doctors call delirium tremens. Delirium tremens involves the following symptoms:

• hallucination
• being very agitated
• increased heart rate
• high blood pressure
• unusually high body temperature (hyperthermia)
• sweating
• confusion
• impaired consciousness
• seizures

These symptoms can begin after 48 hours and last up to 7 days following the change in alcohol consumption. Delirium tremens can also lead to death.

For those with known AUD, it is best to coordinate alcohol reduction or cessation with a healthcare professional so they can proactively manage alcohol withdrawal symptoms.

For unplanned alcohol withdrawal symptoms, seek immediate medical attention to prevent the onset of more serious health problems.

It is best to talk with a doctor if someone suspects they have an AUD. Although not immediately dangerous, like alcohol withdrawal, AUD is a serious condition.

Inpatient and outpatient treatments are available, and these depend on factors including current withdrawal severity and the severity of past withdrawals.

As a 2020 review states, many important steps exist in treating alcohol withdrawal.

In the first instance, doctors will want to manage an individual’s seizures if they have any.

Benzodiazepines form the mainstay of alcohol withdrawal treatment. These medications can reduce the frequency and severity of serious complications, such as seizures and delirium tremens.

Doctors may use benzodiazepines, but carbamazepine, gabapentin, and valproic acid are suitable alternatives, followed by barbiturates. Supportive care measures, such as taking folic acid and thiamine, may also be helpful. Additionally, a doctor may recommend avoiding certain substances, such as caffeine, staying hydrated, and getting adequate sleep.

Useful benzodiazepines include:

• chlordiazepoxide
• clorazepate
• diazepam
• lorazepam
• midazolam

In some cases, heavy alcohol usage can mean that people with alcohol withdrawal do not respond well to benzodiazepines.

Under those circumstances, doctors may use barbiturates instead. The most common barbiturate for alcohol withdrawal is phenobarbital.

Once medical professionals have addressed all immediate risks to the person, outpatient care can begin. This may include visiting support groups and having regular check-in meetings with a healthcare professional.

According to a 2022 paper, the mortality rate for delirium tremens is between 5 and 15% with treatment.

However, this figure is much higher if an individual does not receive medical care. Without appropriate treatment, the mortality rate is around 37%.

AUD is a serious condition. As well as having a detrimental health effect, AUD can create or worsen significant professional and personal challenges. People with AUD should consider seeking support for this condition.

Support can come in many different forms. Some people may benefit from talking with family, friends, and loved ones.

Other individuals may wish to join support groups or programs such as Alcoholics Anonymous. Finally, the National Institutes of Health (NIH) has an excellent resource on how to find treatment for AUD.

This section answers some frequently asked questions about alcohol withdrawal.

What is the mortality rate of alcohol withdrawal syndrome?

The mortality rate for delirium tremens, the most severe form of alcohol withdrawal, is around 37% without treatment.

However, this figure may be as low as 5% if an individual receives prompt and appropriate treatment.

What is the most serious withdrawal symptom associated with alcoholism?

There are many serious symptoms of alcohol withdrawal. These include seizures, hallucinations, and a high body temperature.

Alcohol withdrawal can also cause death, especially without treatment.

What causes sudden death in people with AUD?

Sudden death in the context of AUD is not the same thing as death from alcohol withdrawal. Research suggests that it can arise due to a sudden worsening in liver problems, which AUD can cause.

Heavy drinking may also cause spikes in the risk of serious heart problems. However, scientists remain unsure about how sudden deaths arise from AUD.

Alcohol withdrawal arises when someone with AUD drastically reduces their alcohol intake. This can cause a variety of symptoms, ranging from insomnia to an upset stomach.

As alcohol withdrawal progresses, it can cause more serious issues. These include hallucinations and seizures. Alcohol withdrawal can also be fatal.

However, treatment is effective in improving the survival rate for this condition.