The Risks of Quitting Cold Turkey

Quitting substance use "cold turkey" carries very significant risks if the drug you are discontinuing is alcohol, a benzodiazepine, or an opioid. If you're unfamiliar with the meaning of cold turkey, it is defined as the "abrupt complete cessation of the use of an addictive drug."

Quitting cold turkey is also not advised if you've been using any drug in large amounts or for a long time. This is because you may suffer from extreme withdrawal symptoms upon quitting suddenly, such as with Lexapro withdrawal.

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The Appeal of Quitting Cold Turkey

For people who are heavy users of alcohol or drugs, quitting cold turkey may be more appealing—for a number of reasons. One is because it can be easier to avoid the drug entirely than to use it moderately when your usual mode is to take it in an unrestrained manner.

Plus, some people feel that they can more easily separate themselves from the world of drug use if they do so completely. Quitting cold turkey enables them to avoid all the people, places, and other reminders of the substance so they can start sobriety afresh.

Risks and Withdrawal Symptoms

Quitting some substances cold turkey can be dangerous to do on your own because of the way the nervous system adapts to certain high-dependency drugs. Abruptly stopping these drugs can cause serious and potentially life-threatening medical issues, including seizures, heart problems, and psychosis.

Another danger of quitting cold turkey is that your body loses its tolerance to the substance consumed. So, if you relapse and then take your usual amount of the drug, you have a higher risk of overdose.

Alcohol Withdrawal

Developing delirium tremens (DTs) is the main risk of alcohol withdrawal. Also known as alcohol withdrawal syndrome, this complication can occur when people suddenly stop drinking. It is more likely following long-term, heavy alcohol use and is potentially fatal, with a mortality rate of around 5%.

Symptoms of acute alcohol withdrawal typically begin 6 to 24 hours after a person has their last drink and may include:

• Loss of appetite
• Nausea
• Tremors
• Increased heart rate and blood pressure
• Irritability and restlessness
• Delusions
• Hallucinations
• Seizures
• Hyperthermia

Benzodiazepine Withdrawal

Benzodiazepine withdrawal can also be dangerous, potentially resulting in death if this drug is stopped suddenly. Abruptly quitting benzodiazepines can also result in seizures.

Benzodiazepine withdrawal is common in people who abruptly cease the use of this type of drug after taking it for more than three to four weeks and, in addition to seizures and death, can result in symptoms such as:

• Anxiety
• Confusion
• Delusions
• Depression
• Dizziness or lightheadedness
• Hallucinations
• Headache
• Heart palpitations
• Insomnia
• Muscle aches and pain
• Nausea
• Sweating
• Tremors
• Vision issues
  

Opioid Withdrawal

Long-term use of opioids such as codeine, heroin, oxycodone, and hydrocodone can lead to withdrawal symptoms if they are suddenly stopped. Opioid withdrawal is typically not life-threatening but can still be very uncomfortable, creating symptoms such as:

• Anxiety
• Diarrhea
• Hot and cold flushes
• Insomnia
• Muscle cramps
• Nausea and vomiting
• Perspiration
• Watery discharge from the eyes and nose

It is recommended that individuals withdrawing from opioids be monitored several times a day to ensure that there are no complications, such as the development of seizures.

Lexapro Withdrawal

Lexapro (escitalopram) is an antidepressant typically used to treat major depressive disorder and generalized anxiety disorder. Quitting Lexapro cold turkey can result in withdrawal symptoms.

Common Lexapro withdrawal symptoms when suddenly stopping its use include:

• Dizziness
• Headaches
• Irritability
• Nausea or vomiting
• Nightmares
• Paresthesia (prickling of the skin)

These symptoms typically start within a few days of stopping the drug and can last for several weeks. If you take a higher dose of escitalopram, your risk of experiencing withdrawal may be even greater upon discontinuing its use.

Medical Supervision for Drug Abstinence Is Safest

This does not mean you can't become abstinent from these substances. But if you are quitting alcohol, a benzodiazepine, or an opioid, doing so under the management of a physician who can give you medication helps to safely lessen the effects of withdrawal.

In many cases, a brief time in detox can be the safest option so that medical staff is on hand in case of an emergency. The staff can also help with providing nutrition, hydration, and medications intravenously if you are experiencing significant nausea, vomiting, or diarrhea during your withdrawal.

If you choose to detox on your own, meeting regularly with your healthcare provider can help ensure that you remain well throughout the process. They may prescribe you a medication to make detoxing easier, depending on the drug you are withdrawing from.

When to Call 911

If you or someone you know is showing signs of a heart attack, seizure, or changes in consciousness while quitting cold turkey, immediate medical attention is required. Symptoms of a heart attack may include:

• Shortness of breath
• Chest discomfort or pain
• Pain or discomfort in the arms, jaw, neck, back, or stomach
• Lightheadedness
• Nausea
• Cold sweats