When hiker Joanna Ruth Shields, 37, was found dead near Sykes Hot Springs in California’s Ventana Wilderness, early speculation focused on the possibility of foul play, according to a press release from the Monterey County Sheriff's Office.

However, official coroner's reports later revealed her cause of death to be probable alcohol withdrawal seizures brought on by chronic alcohol use disorder.

Friends who were hiking with Shields said she had gone to the river that morning. A short time later, one of them found her unresponsive in the water, according to reports.

"This is a probable seizure that occurred as a result of chronic alcohol use disorder , but there was nothing that stood out that indicated any type of criminal activity," Andres Rosas, commander and the primary public information officer for the Monterey County Sheriff's Office, told KSBW 8.

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Given the results of the investigation and forensic examination, no further investigation is taking place.

The death of the Big Sur hiker has drawn attention to a medical danger that is often less visible than other risks linked to alcohol dependence. The case was ruled a probable example of fatal alcohol withdrawal seizures.

The incident highlights a little known danger of severe alcohol dependence because suddenly stopping alcohol can trigger life threatening neurological events, according to experts cited in the report.

Alcohol acts as a depressant on the central nervous system. When someone drinks heavily over a prolonged period, the brain adapts by increasing chemical signals to keep bodily systems functioning, according to experts.

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When alcohol is abruptly stopped, that blocker on the central nervous system is removed. The brain can then enter a state of dangerous overexcitation, leading to severe hyperarousal.

Withdrawal symptoms typically begin within six to 24 hours after the last drink. The risk of seizures peaks between 24 and 48 hours.

Alcohol withdrawal can quickly move from tremors, sweating and anxiety to severe seizures and a condition called delirium tremens.

Clinical guidelines from the National Institutes of Health categorize alcohol withdrawal by key progression stages. The early stage may include insomnia, tremors, anxiety, gastrointestinal upset, headache, diaphoresis, heart palpitations, anorexia, nausea, tachycardia and hypertension.

Another stage is marked by visual, auditory or tactile hallucinations.

People in a more advanced stage may experience sudden loss of consciousness accompanied by severe muscle contractions. Another potential symptom is delirium tremens, a medical emergency involving extreme agitation, fever, racing heart, hyperthermia and cardiac instability.

In wilderness settings or isolated locations, a sudden seizure can be especially dangerous, experts note. It can result in immediate loss of consciousness, trauma, respiratory arrest or an inability to seek emergency care.

Attempting to detox without medical supervision can result in sudden loss of consciousness, trauma and death, experts warn.

Health agencies, including the National Institutes of Health, strongly advise that individuals with a history of heavy drinking or prior withdrawal episodes never attempt to detox alone or in remote settings.

Medical detox programs use tailored medication protocols to safely taper brain activity and prevent seizures.

Help is available for people struggling with alcohol use disorder. The Substance Abuse and Mental Health Services Administration National Helpline provides free, confidential treatment referrals 24 hours a day.


Are you feeling overwhelmed or hopeless right now? Have you been withdrawing from people or activities you usually enjoy? Are you having thoughts about hurting yourself, or feeling like things will never improve?

You do not have to handle those feelings alone. Support is available, and talking to someone can make a difference. You can reach out to the 988 Suicide & Crisis Lifeline by calling or texting 988, or by chatting online at 988lifeline.org. Trained counselors are available 24 hours a day to listen and help.

If you believe someone is in immediate danger, call emergency services right away. Even a small step, like reaching out to a trusted friend, family member, or professional, can help create a path forward.