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Winehouse's death points to dangers of detoxing alone

/ Source: contributor

Amy Winehouse’s father says the late singer was off drugs for three years, but she was in a continuous battle with alcohol — and believes that the way she was trying to detox may have killed her, according to an interview with Anderson Cooper that aired Monday.

Mitch Winehouse says he suspects his daughter suffered a seizure and “there was nobody there to rescue her.”

While no one knows for sure the exact circumstances of Winehouse's death, subtance abuse treatment experts say an alcohol detox can be more deadly than most people imagine.

“While you’re withdrawing from other drugs, you may want to die, but alcohol detox is the only actual drug detox you can die from,” says Cyndie Dunkerson, clinical supervisor for Hope By the Sea, an alcohol and drug detox and rehabilitation center in San Juan Capistrano, Calif.

Scoop: Winehouse family shares more details about Amy's death

An estimated 15.2 million Americans battle alcohol abuse and addiction each year, according to the 2008 National Survey on Drug Use and Health. About 5 percent of untreated patients going through acute alcohol withdrawal have seizures, according to a report published in Alcohol Health & Research World. Between 5 and 25 percent of patients die who are going through the severest stage of alcohol withdrawal, delirium tremens (DT's), the report said.

“The body just doesn’t handle getting off of it very well,” says Dunkerson. Of those who don’t survive detox, ”most people, if they are not dying from a gastrointestinal bleed, they die from a really bad grand mal seizure.”

Mitch Winehouse told Cooper the troubled British singing sensation was taking Librium, a drug commonly used to help with an alcohol detox and decrease the chances of seizures and anxiety. Toxicology reports confirmed the presence of Librium in Winehouse's body at the time of her death.

It’s not known whether Librium contributed to Winehouse’s death, but Dr. Philip Gilly, medical director of the Maplegrove Center at Henry Ford Health System in West Bloomfield, Mich., says a seizure can be caused after 24 hours of alcohol withdrawal or withdrawal from long-term use of the medication, part of a class of benzodiazepines which includes other prescription drugs such as Ativan, Klonopin, Xanax and Valium.

Librium can become addictive and can cause medical issues such as dependence, agitation, disorientation, hypertension, anxiety and anorexia if it’s taken much longer than a week. In severe cases, seizures can occur during sudden Librium withdrawal.

“If someone were going to have a benzo withdrawal seizure because of the Librium, it means they were taking it improperly,” Gilly says. “They were taking it longer and more than they would need for alcohol withdrawal. They would have to be taking it every day for more than a month or two.”

Dunkerson explains that during alcohol withdrawal, the body goes through a series of physical and neurological changes, and a simple hangover is a mild form of alcohol withdrawal. If drinking alcohol helps people relax and go to sleep, withdrawal causes the opposite of that.

“Your blood pressure gets really high. You’ll get agitated, hyperactive, anxiety-filled and you will actually get depressed because of all that’s going on," she said. "You can get jaundice and turn yellow from hepatitis inflammation in your liver, and have hallucinations and seizures.”

Drugs and alcohol affect the brain, says Gilly, and seizures are a short circuit in the brain’s electrical circuits. The brain goes through changes when a person starts taking drugs, or comes off them, causing overactive or irritated nerves that can lead to seizures.

Mitch Winehouse said doctors warned his daughter to slowly cut down on drinking, but she didn’t. Dunkerson says that’s exactly what she tells incoming patients who call to say they are going to stop drinking before they arrive for detox. Alcohol withdrawal requires careful monitoring and taking a drug such as Librium to help.

“You need medication assistance in getting through this. Otherwise, you are putting yourself at grave risk,” she says. “Nobody should ever try to quit drinking alcohol on their own if they have been a daily drinker for an extended period of time. My advice is ‘Don’t stop drinking until you get here.’ Get medical attention immediately because between 48 and 72 hours is when you have seizures from an acute withdrawal.”

Alcohol withdrawal, which also can include tremors the first day, seizures and delirium tremens (DTs) within a week, doesn’t have to be deadly, but too often it is, says Dunkerson.

“When I heard the news of Amy Winehouse’s death, I cried because she was such a tortured soul,” she says. “This disease doesn’t have to be fatal, but it is very, very fatal. The only thing I love about my job is getting people to walk out from the dead. The thing I hate about my job is I get to bury the people that don’t make it.”