eli5 why can you not just go into a medically-induced coma to avoid the symptoms of withdrawal?

Question

eli5 why can you not just go into a medically-induced coma to avoid the symptoms of withdrawal?

In: 1430

Answer 1

You can. It’s just not sensible to.

Of the commonly abused substances likely to lead to dependence/addiction, very few lead actual potentially fatal withdrawals: alcohol, benzodiazepines, barbiturates. The last of the three has widely been superseded by benzos since it has a much worse safety profile without much benefits.

All the other substances likely to foster dependence — and even those highly unlikely or virtually impossible to, such as the classical psychedelics (LSD, psilocybin, mescaline, DMT) — aren’t going to kill you even if you quit cold turkey from however massive a habit. Sure, heroin withdrawals after a decade of daily IV use will make you wish you were dead so the pain would stop; but benzo withdrawals will actually just make you dead.

General anaesthesia of any kind is by design just an extremely risky thing. It doesn’t take much at all to result in the patient never regaining consciousness. Sometimes they just never do anyway, even if nothing went wrong. It’s trying to bring you as close to death as possible, and then trying to maintain that precarious balance for however long as is necessary, and then trying to make you come back alive. It’s an exceedingly delicate thing, and plain irresponsible of a thing in terms of a medical procedure for an ailment so trivial and survivable without any medical intervention (except in a very small minority of cases).

Interestingly, one drug that’s utilised to “reverse” the dependence on benzos in some exotic treatment regime not dissimilar to what you’re asking, is flumazenil. Flumazenil acts as an antidote for benzodiazepine overdose, the same way naloxone is for opioids, or ethanol for methanol poisoning. It can potentially “reset” a benzodiazepine dependency when administered. But it can also just as often result in inducing a massive seizure leading to death when administered to an individual with a heavy benzo (or plain GABA-ergic) tolerance.