Dr. Whitsett is Board Certified in Internal Medicine and Addiction Medicine. He is the Medical Director for The Ridge Treatment Center. You can read his full bio here.
I Drink A Lot. Can I Just Quit Drinking Safely?
Some people drink a lot. They often ask can I quit drinking safely? Some people decide they should quit drinking, as they understand that excessive drinking is not healthy. For people who drink to excess, one of the most difficult things to do is to make that decision to quit.
However, before someone decides to just quit drinking, it is important for them to understand that for some people, this can be dangerous, even life threatening.
So how do you know if it is safe to just quit?
Well, it depends.
Most people that drink too much are not physically dependent upon alcohol. Alcohol-dependent individuals must drink every day. When they stop drinking for even 1 day, they suffer symptoms of alcohol withdrawal.
Symptoms of alcohol withdrawal include, but are not limited to:
- hand tremors
- a lot of anxiety
- a racing heart
- body twitches
Rarely symptoms of alcohol withdrawal escalate, leading to “DTs”, or delirium tremens, a life-threatening syndrome that can cause cardiovascular and respiratory failure. Other symptoms of DTs might include confusion, fever, and hallucinations.
In addition, someone who stops drinking abruptly can also suffer seizures, with or without DTs.
If a person is able to stop drinking for 24 hours and they have no withdrawal symptoms such as hand tremors, feeling a lot of anxiety, sweating, nervousness, a racing heart, and body twitches, generally there is no danger of continuing not to drink and medical care with medication is not required.
However, if a person experiences the above mentioned withdrawal symptoms:
- While they are actively cutting down on their drinking, or
- Within 24 hours of quitting drinking
then it is important to seek medical attention.
In general, people at high risk of medical complications coming off alcohol are:
- Those that have a history of DTs.
- Those with a history of seizures.
- Those people with a history of chronic, heavy, daily drinking (usually for weeks or months without a day off).
- Those that have to drink to start the day because of hand tremors or feeling ill.
It is difficult to quantify if there is a specific amount of alcohol consumed that places someone at risk for alcohol withdrawal syndrome and/ or DTs.
While some people can drink large amounts (say a case of beer a day), not everyone that drinks this much has alcohol withdrawal since the ability to withstand alcohol’s physical effects can vary from person to person.
As a general rule (no medical studies to confirm), if a person drinks 13 standard drinks a day for a month, then they have about a 50% chance of having major life-threatening withdrawals.
In instances where a person develops alcohol withdrawal, it is recommended that the person seeks medical attention to assess and advise treatment. Alcohol withdrawal can be lethal. When alcohol withdrawal is medically managed, however, the fatality rate is extremely low.
When we assess a patient with alcohol withdrawal, we check vital signs, a breathalyzer, obtain a brief history and physical and do an assessment called a “CIWA-Ar”, or Clinical Assessment for Alcohol Withdrawal, Revised. This 5-10 step assessment is simple, and can predict if someone is at risk for a mild, moderate or severe alcohol withdrawal syndrome.
When we identify a patient with alcohol withdrawal symptoms, we determine the severity of the withdrawal risk and then place the patient in a level of care appropriate for that particular patient. Most of the time, a patient can be treated with medication as an outpatient; rarely, the patient requires hospitalization.
So, my advice is that if a person is experiencing symptoms that suggest alcohol withdrawal, they should consult with a health care professional and obtain a medical evaluation to determine if they are at risk.
If the person is not at risk, no harm, no foul. But I guarantee that if they are at risk, they will be glad they sought medical attention to manage their withdrawal from alcohol in the safest manner possible.