Monthly Discussion Your chance to join the discussion: Every month we'll add a new topic for you to discuss with the community.
RSAT Forum > Monthly Discussion > May 2023: Alcohol and Drug Withdrawal-Related Deaths View modes: 
skeller - 5/12/2023 9:41:57 AM
May 2023: Alcohol and Drug Withdrawal-Related Deaths

Question: Can withdrawal from alcohol and drugs be lethal?

Answer #1: Yes. And this presents a real challenge as jails have become, by default, the largest detoxification centers in the United States. 

According to the National Institutes of Health National Library of Medicine, while more than 50% of people with a history of alcohol abuse can exhibit alcohol withdrawal systems when they stop drinking or decrease consumption, only 3% to 5% exhibit symptoms of severe alcohol withdrawal, defined as alcohol withdrawal delirium, more commonly known as delirium tremens (DT).  It is known to occur as early as 48 hours after abrupt cessation of alcohol in those with chronic abuse and can last up to five days. It has an anticipated mortality of up to 37% without appropriate treatment. It is crucial to identify early signs of withdrawal because it can become fatal (A. Rahman, 2022). Similarly, opioid, benzodiazepine and methamphetamine withdrawal can also be life-threatening to differing degrees. Opioid withdrawal occurs when a patient who is dependent on opioids suddenly reduces or stops taking opioids. It can also be caused when a patient has an opioid in his/her system and is given an opioid partial agonist like buprenorphine or antagonists like naloxone or naltrexone. While death is a rare side effect it must be considered in responding to withdrawal. Often it is not the drug itself that causes death but the results of the chemicals leaving the individual’s body. The side effects and withdrawal symptoms can be so severe that the body ceases to function or operates at a highly diminished capacity. Quitting opioids “cold turkey” gives the body no time to adjust and can do harm. Persons with an underlying medical condition are at the most significant risk for death. Opioid withdrawal has also been linked to suicide as has withdrawal from methamphetamine. Death related to withdrawal from methamphetamine while not typical can result in severe symptoms of depression and suicidal ideation which can lead to self-harm and death.

Answer #2:  The Bureau of Justice Assistance and National Institute of Corrections have been working with a task force of medical, correctional and other experts to come out with jail withdrawal guidelines. These guidelines should be coming out soon and will be posted on this website’s home page as soon as they do. These will be guidelines, not medical protocols. But they will reveal what jails should be expecting from their contracted or in-house medical providers. They will also indicate the training jail intake personnel require to be able to appropriately screen new admissions to determine if they require withdrawal management or, in worst cases, are not fit for incarceration and should be taken to the nearest medical facility for treatment and clearance before being admitted to the jail. According to the Bureau of Justice Statistics, Jail Inmates in 2020-Statistics Tables, 56% of jails hold fewer than 100 individuals. These jails must often rely on non-medical personnel to screen people entering who are under the influence of alcohol and a variety of substances that may require withdrawal management to prevent life threatening conditions and drug precipitated suicides.