Drug Withdrawal Symptoms, Timelines, and Treatment (2023)

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  • Alcohol Withdrawal

    People with significant alcohol dependence may be at risk of severe withdrawal and should not attempt to quit alcohol “cold turkey” because of the increased likelihood of seizure development or other withdrawal-associated complications. For many, alcohol withdrawal is uncomfortable, but in some instances, it can also prove life-threatening if not appropriately managed through medical detox efforts.

    Alcohol is a central nervous system depressant, or CNS depressant, and abruptly quitting or slowing use after developing dependence can result in potentially dangerous nervous system excitation as the body restores equilibrium. Alcohol withdrawal symptoms may arise within hours of the last drink. Still, some of the more serious risks remain a factor for several days.

    Symptoms of Withdrawal for Alcohol

    Individuals who are dependent on alcohol may experience some of the following distressingalcohol withdrawal symptomswhen trying to quit:2,9

    • Elevated blood pressure
    • Racing pulse
    • Sweating
    • Insomnia
    • Tremors
    • Anxiety
    • Agitation
    • Headache
    • Sweating
    • Nausea/vomiting
    • Hallucinations
    • Seizures

    It is not always that straightforward to predict who is at the highest risk for severe withdrawal and withdrawal complications. However, the likelihood of experiencing significant withdrawal increases with the average quantity and frequency of drinking. People with certain concurrent medical issues, a history of polysubstance use, and those who have experienced previous episodes of alcohol withdrawal may be at additional risk.

    While alcohol withdrawal can start within the first few hours after the last drink, delirium tremens may not start until a few days later, and appear suddenly, making alcohol withdrawal safest when monitored around the clock by medical professionals.

    (Video) Heroin Withdrawal Symptoms and Timeline

    Heroin & Opiate Withdrawal

    Heroinbelongs to the opioid class of drugs. Opioids work by attaching to and activating opioid receptors throughout the body. Opioid receptor activation is associated with a subsequent release of dopamine in the brain, which serves to reinforce the continued use of opioid drugs for their pleasurable effects.10

    Opioids are a widely abused and highly addictive class of drugs. Some degree of opioid dependence may develop after short periods of use, even when taken according to a prescription, in the case of prescription painkillers.

    Opioid medications, when used under the supervision of a medical doctor, successfully alleviate physical pain caused by injury, illness, or surgery. Misuse of these drugs can greatly increase the risk of someone becoming physiologically dependent on them.

    Symptoms of Withdrawal for Opioids

    The acuteopioid withdrawal syndromemay include several characteristic symptoms, such as:8,11

    • Nervousness or anxiety.
    • Trouble sleeping.
    • Frequent yawning.
    • Nausea.
    • Diarrhea.
    • Flu-like symptoms.
    • Muscle cramps/body aches.
    • Runny nose.
    • Excessive sweating.
    • Hot and cold flashes.
    • Goosebumps.

    Although withdrawal from heroin and other opioids is rarely associated with life-threatening complications, enduring the sometimes markedly unpleasant symptoms can present unnecessary challenges to recovery. The mere discomfort of withdrawal—which some describe as mimicking a bad case of the flu—can lead to immense physical and psychological distress.11

    Left unmanaged, opioid withdrawal can easily drive someone toward immediate relapse, which can derail recovery attempts.

    (Video) Opioid Withdrawal

    Benzodiazepine Withdrawal

    Benzodiazepines, or “benzos” as they are sometimes referred to, are a class of drugs that effectively treat anxiety, panic disorder, and certain types of seizure disorders.

    These medications are CNS depressants and work on the brain by increasing activity at receptors for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). This increase in GABA activity also increases inhibition of brain activity, producing a drowsy or calming effect that may be medically beneficial.12

    Some widely prescribed benzodiazepines include:

    • Xanax.
    • Ativan.
    • Klonopin.
    • Valium.

    Symptoms of Withdrawal for Benzodiazepine

    Potential symptoms ofbenzo withdrawalmay include:

    • Anxiety.
    • Agitation.
    • Sweating.
    • Increased heart rate.
    • Trouble sleeping.
    • Nausea and/or vomiting.
    • Hallucinations.
    • Seizures.

    When used as prescribed under the care of a physician, benzos can help many people manage anxiety, panic, and certain other conditions. However, misuse increases the risk of developing significant dependence on these drugs.

    Cocaine Withdrawal

    Cocaineis an exquisitely addictive stimulant drug that influences the brain’s reward center by blocking the removal of dopamine from the synapses.13This effect in the brain reinforces cocaine use and lays the groundwork for eventual compulsive patterns of use. In turn, this can drive the development of physiological dependence to the drug.

    (Video) Drug Withdrawal Symptoms and How to Manage It During Detox

    When someone abruptly stops using cocaine, they may experience a severe, negative change in their mood. A dependent user may experience cocaine withdrawal within the first day of their last use, and their withdrawal symptoms could last weeks.

    Symptoms of Withdrawal for Cocaine

    Cocaine withdrawalis rarely physically dangerous, but may include several distressing psychological symptoms, such as:

    • Depressed mood.
    • Ongoing tiredness or lethargy.
    • Insomnia or hypersomnia.
    • Anxiety.
    • Irritability.
    • Paranoia.
    • Increased appetite.
    • Problems with concentration.
    • Slowed thoughts and movements.
    • Intense drug craving.

    Withdrawal Treatment: When Is Drug Detox Necessary?

    There are certain factors to consider when deciding whether someone should seek medical detox to manage withdrawal.

    Withdrawal can be challenging—and sometimes dangerous—for someone who is first getting sober. If you’re thinking of getting sober, it’s recommended that you seek guidance from a medical professional, who may recommend a medical detox. This way, once withdrawal symptoms appear, they can be managed appropriately by trained medical staff. Withdrawal management is a large part of the medical detox process. It refers to the medical and psychological care of patients who are experiencing withdrawal symptoms as a result of stopping or significantly reducing use of the drug with which they developed a dependence.11

    With many substances, medical detox provides the safest, most comfortable setting for withdrawal management. While in detox, patients can safely rid their bodies of the toxic influence of substances under the care of medical professionals, who can monitor vital signs, such as high body temperature or high blood pressure, and administer medications to prevent or manage severe symptoms.

    The goal of detox is to reach a state of safety and a comfortable level of mental and physical stability. Someone addicted to alcohol, opioids, benzodiazepines, and other sedatives commonly benefit from undergoing medical detox to safely manage withdrawal with the fewest number of adverse consequences. Many facilities also offersame-day admission detoxfor cases that need attention sooner rather than later.

    (Video) Alcohol Withdrawal: Timeline

    How Long Does Detox Last?

    Most patients will complete a drug detox program in a couple days to a week. How long drug detox lasts depends upon a variety of factors, including which drugs someone used, how much of the drug was used, how long the person has been using, as well as the person’s overall health. Typically, detox is the first step of treatment, and patients will enter rehab and therapy to learn coping and recovery techniques.

    What Are The Medications Used In Drug Detox?

    To stabilize someone in withdrawal from certain substances at the start of a longer-term treatment for substance use disorders (SUDs), medical professionals may administer different medications to ease symptoms and decrease the risk of complications.

    For example, some medications that may be used during opioid detox include:11

    • Clonidine: A medication used to lessen certain symptoms of opioid withdrawal, including anxiety, tremor, sweating, and chills.
    • Lofexidine: A recently approved medication in the same class as clonidine used similarly to reduce certain opioid withdrawal symptoms.14
    • Buprenorphine: An FDA-approved partial opioid antagonist medication used to treat opioid use disorder (OUD) that controls cravings and lessens withdrawal symptoms.
    • Methadone: A long-acting, full opioid antagonist medication used to stabilize and maintain people in recovery from OUD.

    Medications for alcohol and sedative withdrawal management may include:

    • Benzodiazepines, which are commonly administered for the management of acute alcohol withdrawal, for seizure prophylaxis, and other symptomatic management, before being tapered off throughout the detox period.9
    • A relatively long-acting benzodiazepine (e.g., diazepam) will first be substituted for the benzodiazepine previously used if the individual has benzodiazepine dependence. Then, it will be tapered slowly to ease withdrawal over a more extended amount of time.8

    Different drugs have varying withdrawal timelines, symptoms, and risks. Treatment must be individually tailored to treat withdrawal from the specific drug, or drugs, to which someone has developed dependence.

    One of the primary goals of medical detox is to facilitate continued, longer-term treatment efforts after the withdrawal period has been successfully managed. Detox, though often hugely important, is not a substitute for additional rehabilitation efforts. Comprehensive rehab care can take place in a residential/inpatient or outpatient setting, depending on individual needs. No matter what the setting, formal substance use treatment commonly begins with a period of detox, followed by ample behavioral therapeutic interventions and continued medical care, as needed.

    (Video) Opiate Withdrawal (The Truthful Timeline/PAWS/Symptoms) Part 1



    How long does withdrawal symptoms last for? ›

    Generally, withdrawal symptoms last 3-7 days. But, the exact length depends on the substance being misused and the severity of the misuse. In some cases, it can take days, weeks, or months to rid the body of substance completely.

    Does withdrawal symptoms go away on its own? ›

    If you chronically, heavily abused alcohol, withdrawal symptoms may begin only a few hours after your last drink. Mild to moderate alcohol withdrawal symptoms typically last a week or two. More severe symptoms can last for several weeks or longer, depending on the situation.

    Can you have withdrawal symptoms after 3 days? ›

    What is the alcohol withdrawal timeline? Symptoms of alcohol withdrawal can occur as early as a few hours after a person's last drink. For some, these symptoms may peak within the first 24–48 hours after alcohol cessation, but they may continue after this point in others.

    What medication is best for withdrawal? ›

    Buprenorphine is the best opioid medication for management of moderate to severe opioid withdrawal. It alleviates withdrawal symptoms and reduces cravings.

    What are the 4 levels of addiction? ›

    While there are many factors that contribute to drug and alcohol addiction, including genetic and environmental influences, socioeconomic status, and preexisting mental health conditions, most professionals within the field of addiction agree that there are four main stages of addiction: experimentation, regular use, ...

    What are 4 of the withdrawal symptoms? ›

    Symptoms can include insomnia, irritability, changing moods, depression, anxiety, aches and pains, cravings, fatigue, hallucinations and nausea. The person may be hot and cold, have goosebumps, or have a runny nose as if they have a cold.

    What are mild withdrawal symptoms? ›

    Early symptoms typically begin in the first 24 hours after you stop using the drug, and they include:
    • muscle aches.
    • restlessness.
    • anxiety.
    • lacrimation (eyes tearing up)
    • runny nose.
    • excessive sweating.
    • inability to sleep.
    • yawning very often.

    What do withdrawals look like? ›

    Fatigue and lethargy are common symptoms caused by many substances because of the toll drugs take on the body. Sweats, shakes, clammy skin, tingles, and feeling cold are other examples. Muscle pains and spasms are seen when withdrawing from drugs like opiates or muscle relaxers.

    What does detoxing feel like? ›

    Extreme Physical Discomfort

    Despite significantly low levels of energy, your body will feel like it's fighting itself, perpetuating your exhaustion even more. Withdrawal causes the body to feel intense pain. You may even notice that it feels as though your body is burning—some say it feels like their body is on fire.

    What are withdrawal slips? ›

    Answer: A withdrawal slip is a written request to the bank to pay the account holder the specified sum. The funds are deducted from the specified account number. A bank withdrawal slip, like a deposit slip, is a record of your banking transaction. It makes it easier for the bank to keep track of your withdrawals.

    How long does withdrawal last antidepressant? ›

    Withdrawal symptoms usually come on within 5 days of stopping the medicine and generally last 1 to 2 weeks. Some people have severe withdrawal symptoms that last for several months or more. See your doctor if you get severe withdrawal symptoms after you stop taking antidepressants.

    How long does it take to go into DTs? ›

    It usually starts about 2 to 3 days after someone who's dependent on alcohol ends a long drinking binge. DTs usually lasts for 2 to 3 days, but symptoms may linger for as long as a week. About 5% of people in alcohol withdrawal get DTs.

    What does dopamine withdrawal feel like? ›

    Withdrawal syndromes are substance specific and commonly include anxiety, panic attacks, dysphoria, irritability, agitation, pain, sleep disturbance, fatigue, orthostatic hypotension, diaphoresis, and drug cravings.

    How long does antipsychotic withdrawal last? ›

    The studies in our review (8, 23–26) reported that most withdrawal symptoms started within 4 weeks after abrupt antipsychotic discontinuation and subsided after up to 4 weeks even though certain symptoms such as hyperkinesia may last for months (23).

    What helps with withdrawal symptoms from antidepressants? ›

    When experiencing withdrawal symptoms or antidepressant discontinuation syndrome, increasing physical exercise or changing the diet to include more fresh food may help ease symptoms by making a person feel reinvigorated and less lethargic.

    How do you talk withdrawal? ›

    How to Pronounce Withdrawal (Free American Accent Training Word of ...

    What are the 4 stages of recovery? ›

    The 4 Stages of Complete Rehabilitation
    • Rest and Protect the Injury. The first stage of recovery is all about minimising further damage and letting the body begin the healing process. ...
    • Recover Your Motion. ...
    • Recover Your Strength. ...
    • Recover Your Function.

    What are the 7 steps of the cycle of addiction? ›

    Understanding each stage and the behaviors associated with each is a valuable way to identify when someone is at risk for an addiction or has already developed one.
    These seven stages are:
    • Initiation.
    • Experimentation.
    • Regular Usage.
    • Risky Usage.
    • Dependence.
    • Addiction.
    • Crisis/Treatment.

    What are the 5 steps of addiction? ›

    What Are the Five Stages of Change? The five stages of addiction recovery are precontemplation, contemplation, preparation, action and maintenance.

    What is withdrawal syndrome list any two symptoms? ›

    Withdrawal symptoms: Abnormal physical or psychological features that follow the abrupt discontinuation of a drug that has the capability of producing physical dependence. In example, common opiates withdrawal symptoms include sweating, goosebumps, vomiting, anxiety, insomnia, and muscle pain.

    What are the withdrawal symptoms of gabapentin? ›

    You might have certain symptoms if you suddenly stop gabapentin: withdrawal symptoms such as agitation, restlessness, anxiety, insomnia, nausea, sweating, or flu-like symptoms. The risks of withdrawal are higher if you're taking high doses or have been on gabapentin for longer than 6 weeks.

    What happens when you stop taking prescription medication? ›

    Discontinuing a medication abruptly can often be associated with unpleasant side effects and worsening of symptoms based on your drug treatment, its chemistry profile, and how your drug is broken down (metabolized) and excreted from your body.

    How can I cleanse my body of toxins naturally? ›

    Full Body Detox: 9 Ways to Rejuvenate Your Body
    1. Limit alcohol. Your liver metabolizes more than 90% of the alcohol you consume ( 3 ). ...
    2. Focus on sleep. ...
    3. Drink more water. ...
    4. Reduce your intake of sugar and processed foods. ...
    5. Eat antioxidant-rich foods. ...
    6. Eat foods high in prebiotics. ...
    7. Decrease your salt intake. ...
    8. Stay active.

    What happens to your body when detoxing? ›

    By doing a detox or minimising the toxins your body has to process, you give your liver the space it needs to start processing these toxins again. Once processed they are released into the lymphatic system, kidneys and blood to be eliminated.

    Is it normal to get sick when detoxing? ›

    Detox pills and diets can use a variety of substances to "purge" the body of toxins. The laxatives, supplements, and even the "helpful" bacteria used in some of these products can cause severe gastrointestinal issues. Some people on detox diets and cleanses can have problems with diarrhea, nausea, and vomiting.

    What do you mean by time deposit? ›

    A time deposit or term deposit (also known as a certificate of deposit in the United States, and as a Guaranteed investment certificate in Canada) is a deposit in a financial institution with a specific maturity date or a period to maturity, commonly referred to as its "term".

    What is a withdrawal form? ›

    More Definitions of Withdrawal Form

    Withdrawal Form means the form to be completed and signed and delivered or submitted to the Administrator in terms whereof the Investor requests the Administrator to redeem a Security prior to the scheduled maturity date of the relevant Product(s).

    What is a canceled check? ›

    Checks that have been paid by the bank they are drawn on. After the money is deducted from your checking account, the bank will cancel the check, so it can no longer be used. You may be asked to provide copies of canceled checks to prove payments for divorce settlement, child support, or other required expenses.

    When do withdrawal symptoms start nicotine? ›

    When do nicotine withdrawal symptoms begin? Nicotine withdrawal symptoms typically begin a few hours after your last dose of nicotine. They peak, or are most intense, on day two or three after going nicotine-free.

    What is a withdrawal syndrome? ›

    Withdrawal syndrome, also known as discontinuation syndrome, occurs in individuals who have developed physiological dependence on a substance and who discontinue or reduce their use of it.

    How long do alcohol shakes last Reddit? ›

    Shakes usually begin with 5 to 10 hours after your last drink and can peak at 24 to 48 hours, and are then accompanied by other symptoms of alcohol withdrawal.


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