Eli5: How does stopping opiates cold turkey kill addicts sometimes?
In: Biology
What does google or Wikipedia tell you?
There’s a [research paper](https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512) that explains it well, but tl;dr: common withdrawal symptoms are vomiting and diahhrea, which can in turn cause you to dehydrate to death.
Asphyxiation from seizures which can happen with withdrawal or vomiting (blocking airway or inhaling it into lungs) or dehydration. Sometimes electrolyte imbalances from vomiting/diarrhea can cause cardiac rhythm disturbances which can be fatal.
People can shit and vomit themselves to death, but it’s not like alcohol or benzos where the act of simply stopping can kill you. It’s more like collateral damage.
You can build an unlimited tolerance to Opioids. Basically, someone who has been abusing narcotics for a long time has likely built up a tolerance so high that they wouldn’t even feel what would be a lethal dose to you or I.
As part of building the tolerance, your body adapts to that much opioid in the system. For example, all the pain begins to build new pathway to transmit the pain the opioid was blocking. (You stop talking the opioid and suddenly the pain is back 10x.) Other physiological effects occur too. Opioids suppress your breathing and reduce the motility of your GI tract. An addict has adapted to all these effects. If you suddenly stop cold turkey, suddenly your breathing and bowels are in hyperdrive… Potentially leading to dehydration.
But the most dangerous part is how quickly you can reverse the tolerance to opioids. If you stop taking your dose for a while, not only do you get all the pain and other issues suddenly attacking you, your body quickly begins to lose its tolerance. After days or weeks of the pain, many people just can’t take it anymore and have a ‘slip’. They go to their dealer just to get a reprieve from the pain and buy their usual dose… Unfortunately, they don’t realize that the dose that made them happy before is now lethal… because they lost so much tolerance.
it doesn’t. while very uncomfortable, opiate withdrawl isn’t lethal. alcohol and benzo withdrawal however are.
No seizures from opiate withdrawal and it can not kill you. ETOH and benzodiazepines withdrawal can cause seizures.
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