Cold Turkey Detox Explained
The phrase “cold turkey” may sound amusing and even somewhat bizarre to anyone who has not gone through drug withdrawal – but for those who have, it can conjure up terrible memories of pain, discomfort and despair.
What is Cold Turkey?
“Cold turkey” refers to the process of a sudden cessation of substance abuse by someone who has a dependence that substance, initiating symptoms of withdrawal; it is contrasted with slowly tapering down dosages over time, or the use of replacement medication in order to manage reduced dosages and minimise the impact of withdrawal.
Cold turkey gets its name from the goosebumps (piloerection) and cold, clammy skin resembling that of a plucked and refrigerated turkey which can result during opioid withdrawal. Although cold turkey traditionally refers specifically to withdrawal from heroin and other opioids, it has come to be used to describe the unassisted withdrawal from any substances of abuse – and in wider parlance, “going cold turkey” may mean the sudden cessation of any activity, not simply substance abuse.
History of Cold Turkey
Opioid withdrawal has been observed since ancient times – the addictive properties of opium have been known for at least 2,000 years – and has been studied medically since at least the 19th century, with the symptoms which give cold turkey its name being associated with the condition by doctors in Victorian Britain and elsewhere. Withdrawal from alcoholism, meanwhile, has also been observed for millennia, and the associated risks have been known and described by doctors for several centuries. As other recreational substances have come to prominence around the world, the withdrawal symptoms associated with them have also been recorded, and withdrawal as a phenomenon is now well understood and described in medical literature.
The phrase “cold turkey” itself is thought to date back to 1877 and a story in popular British satirical magazine Judy in which slices of cold turkey are used as a plot device; one theory is that the “cold turkey treatment” began to be used as a phrase meaning cutting someone off or excommunicating them, and over the following decades this metamorphosed into a way of describing cutting something off.
The use of the phrase to describe a sudden cessation of substance abuse was recorded at least as early as 1920, in a magazine article referring to opiate abuse and dependence specifically; it is uncertain whether this usage of the phrase evolved independently, prompted by the turkey-like symptoms of opioid withdrawal, or whether it was connected to the broader use of the phrase in other contexts.
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Is Cold Turkey Safe?
The symptoms of withdrawal which prompt the comparison with cold turkey skin – goosebumps and cold and clammy skin – are not themselves dangerous. However, the wider process and experience of withdrawal itself can be extremely dangerous, and even fatal.
In the case of some substances – in particular alcohol and benzodiazepines – withdrawal syndrome can kill: seizures, stroke and heart attacks can all be caused by alcohol withdrawal and benzodiazepine withdrawal. While withdrawing from other substances may not pose the same direct risk, nevertheless it can still pose a danger to life: withdrawal symptoms can be so unpleasant, painful and distressing that many people going through withdrawal turn to self-harm or even suicide in an attempt to escape them.
Meanwhile, withdrawal can also lead to an increased risk of overdose: some individuals going through withdrawal may relapse as a means of driving off withdrawal symptoms, but their tolerance to their substance of choice may well have reduced, perhaps significantly, during the period of abstinence, and the dosages to which they were previously accustomed may now be too great for their bodies to handle, meaning that overdose – potentially fatal – can result from relapse.
Why People Perform Cold Turkey
Many people choose to go into withdrawal because they wish to overcome their addictions as soon as possible, and think that it will be easier for them to stop taking their substances of abuse completely rather than to go through a period of tapering. Other addicts may wish to keep their addictions completely secret, including from doctors, and therefore when it comes to attempting to beat their addictions they would rather go through the experience completely independently than sign up for any treatment.
Others still may, for one reason or another, be unable to take any medications which can ease withdrawal, and may be obliged to go through cold turkey even if they would rather have their symptoms eased pharmaceutically.
Meanwhile, many addicts go into withdrawal involuntarily – for example, if their supply of their substance of choice is interrupted, or if they are removed from their normal environment against their will (e.g. if they are arrested or hospitalised, or moved to another location by family members) – and may have no choice but to suffer through cold turkey if they are unable to gain access to other supplies of the substance to which they have a dependence, or to medications or other substances of abuse which can ease withdrawal.
Risks of Cold Turkey
The most significant risks of going cold turkey are those which can result in the death of the withdrawing individual: the symptoms of alcohol and benzodiazepine withdrawal in particular, including seizures, stroke and heart attack, which can cause death; and the risk of overdose associated with relapse after a period of withdrawal. The unpleasantness of withdrawal can also result in self-harm and suicide ideation.
Depression and anxiety are common withdrawal symptoms associated with the majority of substances of abuse, and can lead to a heightened risk of suicide if not addressed.Paranoia and psychosis are also symptoms of some withdrawal syndromes and can lead to the risk of harm to self and others.
Individuals going through withdrawal involuntarily may go to very great lengths to obtain their substances of abuse in order to stave off withdrawal symptoms; this may include criminal activity including theft and prostitution, and violent acts, all of which can have long-term negative consequences for themselves and others.
Physical Symptoms of Cold Turkey
While the goosebumps and clamminess which give the condition its name are typically linked with opioid withdrawal specifically, “going cold turkey” from any substance of abuse can give rise to the manifestation of a huge variety of withdrawal symptoms, varying from one substance to another and from one withdrawing individual to the next.
Some common withdrawal symptoms include:
- cravings
- nausea
- diarrhoea
- muscle spasms
- fluctuating body temperature
- sweating
- headaches
- insomnia
- depression
- anxiety
- changes to appetite
- fatigue
- agitation
- flulike symptoms
- yawning
- accelerated heart rate
- hypertension
- hypotension
- abdominal cramps
- tremors
- goosebumps
- clammy skin
- dysphoria
- problems urinating
- chest pain
- hallucinations
- delirium
- psychosis
- sexual dysfunction
- blurred vision
- impaired concentration
- aphasia
- mood swings
- paranoia
- photophobia
- restless leg syndrome
- seizures
- coma
- death
Why Medically Supervised Detox and Withdrawal is the Safest
Because of the risk to health – and in some cases to life – which withdrawal syndrome can entail, it is vital that you do not attempt to go through withdrawal without medical help. Regardless of whether or not medication may be prescribed to ease some of your withdrawal symptoms, being monitored by health professionals while you go through withdrawal can make the difference between life and death.
Safe Detoxing and Withdrawal Timelines
What constitutes a “safe” period of detox and withdrawal should be determined by medical professional – another reason why withdrawing independently should never be attempted.
Coping with a Withdrawal
Withdrawal can be a very difficult experience, but in the long term it is worth it: a life without substance abuse is infinitely preferable to addiction. Various coping strategies may be employed during a withdrawal; speak with your doctor and/or an addiction specialist about how to get through withdrawal.
Choosing a Treatment Centre
A number of facilities now operate across the UK providing addiction treatment services including managed detox and withdrawal. However, not every facility might be suitable for you: if you are contemplating addiction treatment, contact an addiction specialist to discuss your situation and specific needs and for information on facilities which might be appropriate for your situation.
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Residential Treatment Centres vs. Outpatient Services
Residential rehabilitation (rehab) facilities often offer treatment services on both an inpatient and outpatient basis. Which is better for you will depend on your own particular wishes and requirements.
Inpatient treatment programme
Inpatient addiction treatment takes place in a secure, confidential, calm and pleasant environment in which you can focus on healing and recovery. Treatment programmes (typically lasting 30 to 90 days) usually consist of detox/withdrawal and therapy phases, with other elements including bespoke dietary and fitness plans and aftercare plans. Medical and psychiatric professionals will be on site to ensure the safety and comfort of clients.
Outpatient treatment programme
If you are unable to set aside the time required for an inpatient programme, you may prefer to opt for outpatient treatment, visiting the facility for appointments and having phone and email contact, and engaging in other aspects of the programme in your own time. However, outpatient treatment will not take you out of your environment of substance abuse and addiction, increasing the likelihood of relapse and treatment failure.
Advantages of Inpatient Treatment and Rehab Centres
If you go through treatment as an inpatient, you have the comfort and security of knowing that medical professionals are at hand at all times; you will also be unable to access substances of abuse, and therefore to relapse. You can focus wholly on your recovery, engaging in therapy which can help you prepare for a life without addiction, and can have the support of other clients who understand the experience of addiction.
Private Rehabs and Confidentiality
Because of the stigma associated with addiction, it is vital that addicts in treatment feel confident that their situation will not become common knowledge. As a result, confidentiality and secrecy are top priorities for private rehabs. If you have concerns about confidentiality, speak with an addiction specialist about how rehabs ensure client details remain private.
Treatment Near Home vs. Different City or County
Some people requiring addiction treatment prefer to choose facilities close to their homes, so that they have the comfort of knowing that love ones are nearby, and making visits easier. Others, however, prefer to put as much distance as possible between themselves and their environment of substance abuse, and therefore choose facilities far from where they live. Where you choose to enter treatment will very much depend upon your own preferences.
Questions to Ask Treatment Centres
Some questions to ask before selecting a treatment facility include:
- What should I expect from rehab?
- How long should I expect to stay in residential treatment?
- What is the facility’s environment like?
- What therapy methodologies are on offer?
- What payment options do you have?
- Should my family get involved in my treatment?
- What is the aftercare plan?
- What is your success rate?
The Role of Counselling in Treatment and Rehab
Counselling and therapy lie at the core of addiction treatment, revealing and addressing the causes of addiction and preparing the addict for life after treatment. A wide variety of different counselling and therapy models can be provided both in and after rehab; if you are contemplating treatment, ask about the therapy options open to you.
Helping the Addict
If someone you know is struggling with an addiction, it is understandable that you will wish to help them – but confronting them without advice can do a great deal more harm than good. Speak with an addiction specialist about the best way to help an addict – and always remember to prioritise your safety and that of anyone around you.
Life After Rehab
Recovery does not end when you walk out of a rehab facility – indeed, in many ways the hardest work is just beginning. It is important to remember that you need to work on recovery every day, using the tools and strategies you have learnt in therapy. However, your life after addiction will be immeasurably healthier and happier than it was before, and the work needed to sustain recovery is more than worthwhile.
Staying Clean and Sober
if you have achieved abstinence and sobriety, you have changed your life infinitely for the better – now, make sure you can sustain that change. Staying clean is an ongoing challenge – but you don’t have to do it alone. Attending self-help group meetings and engaging in counselling can help you maintain your sobriety; speak with an addiction specialist about support options in your area.
Avoiding Relapse During Drug Cold Turkey
Avoiding relapse during cold turkey is imperative, not only to ensure the success of the detox process but to avoid the risk of fatal overdose. A range of relapse avoidance strategies and techniques will be taught during therapy in a treatment programme, but if you are seeking to go through withdrawal outside residential rehab (for example as an outpatient) speak with a doctor or an addiction specialist about tips on avoiding relapse during the process.
Get Help Today
If you are struggling with an addiction, it is understandable that the fear of withdrawal may be putting you off seeking treatment. However, you can get help with withdrawal and with all other aspects of your addiction, and can achieve a life without substance abuse. Get in touch with your GP and/or an addiction specialist today and take the first steps on the path back to the sober life you want and deserve.
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