Going “Cold Turkey” Dangerous, Study Finds

Withdrawal is the accepted term for a collection of unpleasant, sometimes dangerous mental and physical changes that occur when people dependent on drugs or alcohol either quickly taper off their intake levels or completely halt their substance intake. As a rule, addiction specialists go to great lengths to address and control withdrawal-related symptoms during the recovery process. In a study published in November 2013 in the journal Brain, Behavior and Immunity, researchers from Georgetown University assessed the potential damage to mental function that can occur when dependent or addicted people suddenly halt substance use on their own. This approach commonly triggers a form of rapid withdrawal called “cold turkey” withdrawal.

Withdrawal Basics

Substance users who curtail their normal levels of intake go through withdrawal because their brains have grown accustomed to the chemical changes triggered by prolonged (and often excessive) exposure to alcohol or a range of addictive drugs and medications. Without the expected presence of a given substance, the brain reacts in ways that trigger mild to severe disruptions in the function of various organ systems. These disruptions last for a limited amount of time as an affected person’s brain and body readjust to their new chemical environment. In many cases, the intensity of withdrawal leads to a return to substance use before an individual can make the adjustments needed to maintain a substance-free daily routine.

As a rule, the unpleasant symptoms that appear during withdrawal represent a reversal of the pleasant sensations that characterize the substance in question. Perhaps the most dangerous form of withdrawal occurs in people addicted to alcohol; in a worst-case scenario, these individuals can develop severe seizures and experience a potentially deadly withdrawal syndrome called delirium tremens. Other substances noted for their ability to produce prominent (if medically less serious) withdrawal symptoms include opioid drugs and medications, stimulant drugs and medications, sedative-hypnotic medications, cannabis and nicotine-containing tobacco. The American Psychiatric Association classifies withdrawal from all of these substances as diagnosable mental health conditions.

Typical Withdrawal Treatment

Doctors refer to medically controlled withdrawal from substance use as detoxification. Typically, the goal of detoxification is to sever the reliance on substance intake as rapidly as possible while fully safeguarding the health of the person going through the recovery process. The specific methods used to control the effects of withdrawal vary according to the substance in question. Commonly used techniques include incrementally diminishing the availability of a substance over a predetermined period of time and using less dangerous substances as short-term alternatives to an addictive drug or medication. People with relatively moderate addictions can often go through periodically monitored withdrawal while continuing to live on their own; however, people with entrenched addictions frequently need to go through withdrawal in an inpatient facility or hospital.

Potential Consequences of Going “Cold Turkey”

In the study published in Brain, Behavior and Immunity, the Georgetown University researchers used laboratory experiments with rats to examine what happens when cold turkey withdrawal replaces the gradual, monitored withdrawal process typically employed by addiction specialists. All of the rats used in the study were chemically addicted to the opioid medication morphine. Some of these animals were allowed to continue a diminished form of drug use after developing an addiction, and therefore experienced a controlled form of drug withdrawal. Others, however, had their drug use suspended abruptly and therefore went through rapid, medically uncontrolled withdrawal. In order to determine the consequences of this untreated withdrawal, the researchers looked for signs of damaging inflammation inside the brains of the affected rats.

After assessing the results of their experiment, the researchers found that the rats that went through uncontrolled drug withdrawal had unusually increased levels of brain inflammation. In fact, the detected levels of inflammation were high enough to potentially damage brain function and contribute to a substantial decline in mental health. On the other hand, the rats that went through controlled drug withdrawal experienced an increased output of certain brain chemicals that essentially protect the brain from damaging inflammation. In turn, this protection helped prevent any declines in mental function.

Significance and Considerations

The authors of the study believe that their work demonstrates the potential for cold turkey withdrawal to significantly damage the mental health of people attempting to recover from substance use. The scope of their findings may be limited by the use of non-human testing and the focus on a single drug of abuse. However, the authors believe that future researchers can use their findings as the basis for an increased understanding of what can happen when people attempt to quit substance use on their own.

Posted on December 4th, 2013

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