If your loved one is showing seizures, severe confusion, hallucinations, a racing heart, or a high fever during withdrawal, call 911 or get them to the nearest ER. The rest of this page can wait.
So, here's what most families don't know: not all withdrawals are equal. Some are miserable but safe to ride out at home. Two of them can kill a person. Knowing the difference is part of keeping your loved one alive.
This is general information, not medical advice. When in doubt, call a doctor.
Withdrawals that can be life-threatening
Alcohol. Severe alcohol withdrawal — sometimes called delirium tremens, or DTs — kills somewhere between 1 and 5% of people who go through it without care. Seizures. Heart arrhythmia. Severe confusion. If your loved one drinks heavily every day and decides to stop cold, they need medical detox. Not a hotel room. Not a basement. A medical detox.
Benzodiazepines. Xanax, Klonopin, Ativan, Valium, and similar. Long-term, daily benzo use needs a slow, medically supervised taper. Stopping abruptly can cause seizures and, rarely, death. This is also why benzos are not something to flush down the toilet to "help" someone quit.
If either is in the picture, do not let them detox alone. Call a detox center. Call your doctor. Call your loved one's prescriber. Most insurance plans cover detox.
Withdrawals that are awful but not usually deadly
Opioids. Heroin, fentanyl, oxycodone, hydrocodone, and others. Withdrawal feels like the worst flu of someone's life — vomiting, diarrhea, body aches, anxiety, no sleep — but rarely kills a healthy adult. Two real risks: dehydration (drink water and electrolytes), and the lowered tolerance that follows withdrawal. People die after detox by using their old dose on a body that can't handle it anymore. Naloxone in the house is essential.
Stimulants. Cocaine, methamphetamine, prescription amphetamines. Withdrawal is mostly emotional — heavy depression, suicidal thoughts, exhaustion, intense cravings. The risk here is suicide. Read our suicide risk page if this is the picture.
Cannabis. Real, but not dangerous. Sleep disruption, irritability, low appetite for a week or two.
Warning signs that need a 911 call right now
- A seizure.
- Severe confusion. Not knowing where they are or who you are.
- Hallucinations — seeing or hearing things that aren't there.
- A heart rate over 120 at rest, especially with sweating and shakes.
- Fever over 101°F during alcohol withdrawal.
- A suicide threat or attempt.
Don't try to drive someone in this state. Call 911.
How to set up a safe detox
- Call a detox center directly. Many will do a same-day intake.
- Most insurance plans cover medical detox. Ask the detox center to verify benefits while you're on the phone.
- A primary care doctor or addiction medicine doctor can sometimes set up an outpatient taper for benzos or alcohol if the case is mild and supervised.
- A "social detox" (no medication, just supervision) is fine for opioids and stimulants. It is not appropriate for heavy alcohol or daily benzo use.
What you can do at home, while it's safe
- Hydration. Pedialyte or Gatorade beats plain water during opioid withdrawal.
- Quiet, low light, soft food.
- Don't moralize during withdrawal. Their nervous system is on fire.
- Keep the phone close. Things can change quickly.
A word on tolerance
After any stretch of not using — detox, residential, jail, hospital — tolerance drops fast. The dose that felt normal three weeks ago can be fatal now. This is the most common moment of overdose death. Talk about it openly before it's a problem.
You aren't a doctor. You're not supposed to be. Knowing what's a medical emergency and what isn't is enough.