Cold turkey

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Cold withdrawal (from the English expression cold turkey ) is the slang term for a sudden withdrawal of physically addictive substances such as alcohol or opiates . As a result, physical withdrawal syndromes also occur in addition to the mental ones , which can vary greatly depending on the addictive substance and the degree of dependence. The physical withdrawal, i.e. H. Detoxification is always only the first step in addiction therapy.

Untreated withdrawal syndromes pose a major health risk, sometimes even being fatal, and their course cannot be foreseen, which is why cold withdrawal without medical supervision is not recommended. Cold withdrawal often occurs unintentionally when the addict is unable to obtain the addictive substance, e.g. B. in acute illnesses. In addition, addicts try cold withdrawal alone when the feeling of shame is too great and they shy away from receiving professional help or when they think they can handle the withdrawal on their own.

If a substitution agent is used during withdrawal, it is referred to as a “warm” withdrawal. In addition to the substitution of the addictive substance, drug therapy aims to alleviate the withdrawal symptoms.

A revolving door effect can be observed in both cold and warm withdrawal ; d. H. the drug user commutes - regardless of whether he is undergoing substitution therapy - between drug use and phases of withdrawal.

Cold withdrawal from alcoholism

The first withdrawal symptoms can appear in addicts four to twelve hours after the last alcohol consumption and last for up to five days with continued abstinence. Stomach pain and discomfort are some of the most common, albeit milder, symptoms. The dysregulation of the autonomic nervous system leads to profuse sweating, dry mouth and circulatory problems such as palpitations and high blood pressure , possibly with blood pressure crises.

The elimination of the dampening alcohol leads to tremors, speech, visual and sensory disorders. In addition, the brain's seizure threshold drops , so that generalized seizures with the potential for injury from falls, aspiration and tongue bites are common. In addition, metabolic imbalances such as hypoglycaemia can occur.

Psychological withdrawal symptoms range from inner irritability and restlessness to concentration and memory disorders with increased suggestibility to depressive moods and suicidal thoughts. Considerations that revolve around the procurement of alcohol are the norm for alcoholics on withdrawal.

Cold withdrawal can lead to delirium , which often requires intensive care.

Cold withdrawal in opiate addiction

When withdrawing from heroin, the symptoms ( opioid withdrawal syndrome ) peak 36 to 72 hours after the last dose. Withdrawal from buprenorphine is experienced as milder than from methadone . The consequences for substitution therapy of opioid addicts are that many patients want to switch from methadone to buprenorphine or prefer the latter from the outset.

Representation in art and culture

In 1969 John Lennon released the single Cold Turkey , in which he celebrated the effects of cold withdrawal.

The topic was also taken up on film, as in 1970 in Trash .

In the 1975 American film French Connection II , the police officer Doyle is first made addicted to drugs and then subjected to cold withdrawal. In the biographical book Wir Kinder vom Bahnhof Zoo from 1978, Christiane F.'s father locks them in their apartment in order to force them into withdrawal. The book was also made into a film in 1981 as Christiane F. - Wir Kinder vom Bahnhof Zoo , but it also had a reputation for playing down heroin addiction.

After that, it became more common to describe or document cold withdrawal in detail in connection with the depiction of drug addicts . a .:

Individual evidence

  1. Florian Schäffler and Sarah Zimmermann: Acceptance-oriented drug work - drug addiction in Bavarian prisons ( Memento of the original from December 5, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , 2012 (PDF; 564 kB). Retrieved August 27, 2013. @1@ 2Template: Webachiv / IABot /
  2. Alcohol withdrawal symptoms: How does cold withdrawal work? Advice on .
  3. ^ Warren K. Bickel, Leslie Amass, Buprenorphine treatment of opioid dependence: A review. In: Experimental and Clinical Psychopharmacology , Vol 3 (4), Nov 1995, pp. 477-489, doi: 10.1037 / 1064-1297.3.4.477 .
  4. Nicholas Seivewright, assisted by Mark Parry: Community Treatment of Drug Misuse: More Than Methadone . Cambridge University Press, 2009
  5. Astrid Hildegard Baur: Influence of substitution treatment and co-use behavior on low-threshold opiate detoxification , 2006 (PDF; 1.3 MB). Retrieved August 27, 2013.