Drug Withdrawal

Recovering from drug addiction is a process that requires several steps beginning with stopping and detoxing from drugs. Since the body adjusts to the substances a person uses, stopping their use may result in withdrawal symptoms. The symptoms are simply the body’s way of returning to a naturally balanced state. Withdrawal is different for everyone—depending on the drug used, length of time one used the drug(s), and how frequently one has been using. Detoxification is an individualized experience. However, despite some of the more uncomfortable symptoms, withdrawal can be managed successfully to begin the recovery process.

Drug Withdrawal Overview

Withdrawal is the natural process the body goes through to cleanse itself when someone who has developed a substance abuse disorder stops using. When an individual uses drugs, their body develops a physical and mental dependence on the substance. Many drugs cause dopamine spikes in the brain that lead to feelings of happiness and euphoria, in other words, a “high,” and the body will need to produce dopamine without the aid of a drug.

The longer drug use continues, the more dependent on the drug the brain becomes to produce the dopamine transmitters. Therefore, when the drugs are removed from the body, the brain struggles to produce feelings of happiness and euphoria on its own. This is one of the side effects of withdrawal from drugs—withdrawal can also lead to many other physical and emotional symptoms, some of which are extremely harmful or even fatal without medical supervision. 

The severity of withdrawal symptoms depends on many things. Factors that can influence withdrawal include what drug(s) was/were being abused, how long they had been abused, whether a person is physically dependent on the drug(s), and the actual method of withdrawal itself. Those who withdraw by the “cold turkey” method, completely halting their use of drugs all at once, may have much more severe symptoms than someone who gradually reduces the amount of the substance within their system through a tapered approach. 

Here is a rough timeline of withdrawal depending on the type of drug that had been abused:

1. Short-acting opioids - such as heroin and prescription painkillers

   Symptoms generally begin 8-24 hours post-ingestion and last about 4-10 days.

2. Long-acting opioids - such as methadone

   Symptoms emerge around 2-4 days post-ingestion and last about ten days.

3. Benzodiazepines - such as Xanax and Valium

   Symptoms begin 1-4 days post-ingestion and peak in about two weeks, but withdrawal can last months or even years without treatment.

4. Cocaine

   Symptoms begin just hours post-ingestion and last from about one to 10 weeks.

Symptoms also vary depending on what drug had been abused and depend on the physiology of who was using and the details of their addiction.

Drug Withdrawal Symptoms

There are a variety of different withdrawal symptoms. In general, the symptoms produced are the opposite of the feelings from using the drug. For example, if the drug a person is withdrawing from is an opiate meant to increase dopamine levels and excitement, withdrawal symptoms may include feelings of fatigue or anxiety. In general, if you or a loved on halts drug use or slowly reduces drug use, any abnormal or uncomfortable feelings they may have are likely withdrawal symptoms and should be monitored.

Some of the most common withdrawal symptoms include:

• Nervousness or anxiety

• Insomnia

• Drowsiness or frequent yawning

• Flu-like symptoms

• Nausea

• Diarrhea

• Hot and cold flashes

• Runny nose

• Excessive sweating

• Goosebumps

• Muscle cramps and body aches

• Depression

• Irritation

• Psychotic episodes

• Hallucinations

• Thoughts of self-harm

• Lethargy

• Tremors or even seizures

While most of these withdrawal symptoms are not immediately fatal, many of them, if unsupervised, can become dangerous if not monitored. It is recommended that anyone suffering from substance use disorder that decides to withdraw seeks professional supervision.

For some drugs such as opiates, medications can help lessen the effects of withdrawal symptoms and to further the detoxification process. Additionally, withdrawal is only the first step in the broader recovery process, so seeking therapeutic help after detoxification is essential to long term recovery treatment.