Why is alcohol withdrawal more deadly in comparison to “harder” drugs like heroin?
In: Biology
Because body.
A non ‘drug’ like a beta blocker for blood pressure can kill you if you suddenly stop taking it.
That’s because the body normally tries to compensate for whatever outside influences, to keep a steady state, and thus gets ‘used’ to a drug or medication to some degree (but rarely fully or most medications couldn’t be used long term).
That’s the reason for people abusing drug taking more and more as the time progresses: the body develops a tolerance thus they need more to get the same pleasant effects.
Now how deadly suddenly stopping the drug or medication is really doesn’t much care for whatever positive pleasant effects you get, but rather how sensitive the bodies subsystem is to sudden changes, and whether even small changes can cause permanent harm
In opioids like heroin, there’s not much that can go wrong as permanent harm in the body when the drug suddenly disappears. The opposite effects of opioids is just feeling extremely bad. Like a severe flu or Covid infection, including runny nose and whole body aches etc.
But there’s nothing of those symptoms that are an imminent threat to life.
Because the body itself can keep running with zero opioids existing in the first place.
Alcohol on the other hand, interferes with a much more basic system of brain regulation of agitation/relaxation.
Normally a neurotransmitter called GABA is used by parts of the brain to tell other nerve cells to keep calm and stop messaging too much.
This is very strictly regulated
Alcohol mimics this gaba. And once the nerve cells get used to being told to keep it down all the time, they reduce how much they keep it down to the same amount of gaba.
So when a person addicted to alcohol suddenly stops it, the brain will still continue producing the same amount of gaba. But now the nerve cells have stopped listening to that signal to calm down. So they will send more signals, and a beyond a threshold this excessive signalling leads to every cell signalling all at once, which is a seizure.
That’s also why benzodiazepines like Xanax have the exact same withdrawal effects as alcohol when quit cold turkey.
They work on the same gaba receptors, just more specifically and ‘clean’ so you don’t get all the side effects of alcohol when you use them.
But quit Xanax cold turkey, the same happens, all the nerve cells (neurons) start firing at random and rapidly because they have lost the ability to regulate when seeing normal levels of GABA
That’s also why amphetamines and meth have the most minor cold turkey symptoms: the body and mind used to constant stimulation just goes to the opposite and you feel extremely lethargic and tired, your blood pressure drops etc.
But the tolerance to the blood pressure increasing side effect of amphetamines specifically is rather minor, so withdrawal just causes your blood pressure drop to healthy low levels rather than dangerous low levels.
Basically the body tries to regulate itself to compensate for any drug or medication you take to some degree. The more your body can adapt the stronger the effects of withdrawal. But whether withdrawal is directly lethal or ‘just’ extreme suffering, depends on the exact sub system of the body the drug affects, and whether a sudden opposite effect could threaten your life.
Hence stopping beta blockers which do the opposite for blood pressure as amphetamines being dangerous, whereas suddenly stopping amphetamines being ‘healthy’.
It’s the same blood pressure regulation system they work on, but a sudden increase in blood pressure just happens to be much more risky than a sudden (moderate) decrease (especially because the body happens to have other ways to keep nlood pressure from going too low, but doesn’t have any when it artificially shoots up£
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