Drug withdrawal can occur when a long-term user stops taking the substance and experiences symptoms due to the filtering of the drug from their system. Withdrawal is more likely if the user has built up a tolerance to the substance.1
The withdrawal symptoms experienced as well as the severity of the symptoms will depend on factors such as tolerance, type of drug, and how someone’s body reacts to the drug and the withdrawal. If the user finds withdrawal symptoms unbearable, they may begin using the substance again.1
Below, you’ll learn more about:
- What withdrawal is.
- Common withdrawal symptoms that effect the physical body as well as mental ability.
- Withdrawal timelines of common substances.
- How to safely detox from a substance to avoid or manage dangerous withdrawal symptoms.
What Is Withdrawal?
In 2018, approximately 20.3 million Americans aged 12 or older struggled with a substance use disorder in 2018. Drug and alcohol addiction is a chronic, treatable disease that impacts regions of the brain and its circuitry and is influenced by an individual’s behavior, genetics, and environment.2
One characteristic of drug addiction is drug dependence.3 When someone uses drugs regularly, their body adapts to the drug requiring more of it to experience its effects. This adaptation is called “tolerance.” Once tolerance to a substance has occurred, a person is likely to experience withdrawal symptoms if they reduce or stop taking the drug.1, 3
Common Physical Symptoms of Drug Withdrawal
Drug withdrawal symptoms vary depending on the type of drug that was used. Withdrawal symptoms can range from mild physical discomfort to severe life-threatening symptoms such as seizures or cardiovascular collapse. In general, a handful of common physical withdrawal symptoms include:4
- Sweating and/or chills.
- Stomach and digestion problems (e.g.,abdominal cramping, nausea, vomiting, diarrhea, etc.)
- Loss of appetite.
- Problems sleeping, including insomnia and/or fatigue.
- Rapid heart rate and palpitations.
More severe physical withdrawal symptoms can include seizures, which can happen in benzodiazepine, stimulant, and alcohol withdrawal.4
Common Psychological Symptoms of Drug Withdrawal
Drug withdrawal encompasses both physical and emotional symptoms. Some substances, like alcohol, may have intense emotional withdrawal symptoms. Some common psychological symptoms include:4
- Mood changes or mood swings.
- Feeling unsettled or unstable.
- Intense fear disproportionate to societal norms.
- Intense feelings of sadness.
- Inability to feel pleasure.
- Confusion or difficulty thinking clearly.
- Poor concentration.
Levels of various neurotransmitters that help to regulate moods, induce feelings of happiness, and are crucial for learning habits, are impacted by drug abuse and dependence.5, 6 During drug withdrawal, the body may be depleted of these neurotransmitters, which contributes to individuals feeling some of the symptoms of the above list.
Irritability is a symptom of many different substances’ withdrawals.4 During drug withdrawal, individuals often have trouble thinking clearly and concentrating, and short-term memory functions may be impaired.
Individuals may be at a higher risk for depression, leading to suicidal thoughts, ideations, or actions during drug withdrawal, making medical detox and professional help all the more necessary.4
Safe Detox to Manage Withdrawal Symptoms
Detoxing from any substance can be an uncomfortable, difficult process. Although quitting “cold turkey” is possible for some people, it is not safe in all instances and may not be as effective in the long term.4 A study comparing individuals who quit drinking “cold turkey” vs. those who obtained help found that those quitting without assistance were less likely to achieve sobriety for a three-year period and were more likely to relapse.4, 7
A medically supervised detox allows the patient to be monitored and kept safe and comfortable during the withdrawal process. This is important for users detoxing from drugs that carry dangerous and life-threatening withdrawal symptoms.4
If you or a loved one are ready to quit using substances, we can help. Oxford Treatment Center, as well as other facilities owned by American Addiction Centers, offer safe medical detox and evidence-based treatments and therapies to help you build a solid foundation for your recovery. Give us a call at 662-638-0015 for more information.
Variables in Substance Withdrawal
Drug withdrawal symptoms vary from person to person, and their severity largely relies on the level of dependence on the drug. The longer a person has used the drug in question, the more severe the potential dependency. Drug withdrawal symptoms can also be severe if the user consumes higher doses.
The route of administration, the amount used at a time, and polydrug (using more than one drug at time) abuse can all influence drug dependency and may complicate withdrawal and treatment. Biological factors, such as metabolism, age, gender, and any medical or mental health conditions, also play a role in the intensity of drug withdrawal.
Genetics and personal or family history of addiction also factors in. Environmental aspects, like home life and exposure to trauma and stress, can also influence the severity of drug dependence and therefore the significance and duration of the withdrawal syndrome.
Drug withdrawal begins as soon as the drug stops being active in a person’s body, and differs depending on the drug involved.4 Typically, opioid withdrawal begins about 12 hours after the last dose (closer to 30 hours for longer-acting opioids like methadone), the National Library of Medicine (NLM) reports. Stimulant drugs like cocaine are usually fast-acting and wear off quickly, so withdrawal symptoms may start sooner.
For most drugs, withdrawal symptoms typically peak within the first few days of stopping use and then start to gradually lessen over time. Acute withdrawal usually refers to the bulk of a person’s withdrawal symptoms and tends to follow a general timeline:
- Marijuana: 1-3 weeks8
- Alcohol: 4-6 days9
- Opioids: 1-2 weeks10
- Stimulants: Several days to a few weeks4
- Benzodiazepines: A couple of days to 4-5 weeks11
After acute withdrawal, symptoms are mostly resolved, although sometimes people may suffer from protracted, or chronic, withdrawal. Protracted withdrawal syndrome can include:12
- Ongoing drug cravings.
- Sleep and mood disturbances.
- Physical pain.
- Decreased energy levels.
- An inability to feel pleasure.
- Difficulties with memory and the ability to think clearly.
Protracted withdrawal may continue for several weeks or even months without professional help.12
The presence of co-occurring mental health disorders simultaneously with drug dependence and addiction can complicate and exacerbate withdrawal symptoms. When co-occurring disorders are present, integrated and comprehensive care models work to manage the side effects of both disorders at the same time, as each disorder may contribute to the other.13
Drug withdrawal symptoms can be successfully managed with the help of medications and a high level of supportive care that is provided through a medical detox program and follow-up treatment.
- National Institute on Drug Abuse. (2018). Glossary.
- American Society of Addiction Medicine. (2019). Definition of addiction.
- National Institute on Drug Abuse. (2018). Is there a difference between physical dependence and addiction?
- Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. Rockville, MD: Center for Substance Abuse Treatment.
- National Institute on Drug Abuse. (2018). Drugs and the brain.
- National Institute on Drug Abuse. (2017). Impact of drugs on neurotransmission.
- Moos, R.H. & Moos, B.S. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction 101(2), 212-222.
- Budney, A. J., Roffman, R., Stephens, R. S., & Walker, D. (2007). Marijuana dependence and its treatment. Addiction Science & Clinical Practice, 4(1), 4–16.
- U.S. National Library of Medicine. (2019). Alcohol withdrawal.
- Substance Abuse and Mental Health Treatment Services Administration. (2020). TIP 63: Medications for Opioid Use Disorder.
- Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington D.C.: American Psychiatric Association.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. (2010). Protracted withdrawal.
- Substance Abuse and Mental Health Treatment Services Administration. (2020). TIP 42: Substance use disorder treatment for people with co-occurring disorders.