Withdrawal is the first stage of recovery from drug and alcohol dependence, and is usually the first stage of treatment at an addiction rehab center.
Withdrawal affects everyone differently based on factors such as the type of substance used and the severity of dependence or the addiction. Knowing more about how withdrawal works can help you prepare yourself or a loved one for this necessary and highly therapeutic experience.
Continue reading to learn more about why withdrawal happens and how it can be safely and effectively treated at a drug and alcohol rehab center.
What Is Drug and Alcohol Withdrawal?
Drug and alcohol withdrawal refers to the set of symptoms you experience when you abruptly stop using these substances after becoming physically dependent on them.
Physical dependence on drugs and alcohol occurs in people who use high amounts of these substances on a regular basis for a period of time. For example, if you’re male, the National Institutes of Health (NIH) defines moderate drinking as two drinks or less per day and heavy drinking as more than four drinks per day.
If you’re a male who consumes a six-pack of beer every day, you are at an increased risk for developing alcohol dependence, or alcohol use disorder, due to drinking high amounts of alcohol regularly.
Every type of substance produces its own unique set of withdrawal symptoms based on its drug class and how it interacts with your body and brain. For instance, alcohol and benzodiazepines produce sedative effects that slow down the central nervous system to help you feel relaxed and less anxious.
Therefore, if you suddenly stop using these substances after using them for a long period, your central nervous system will speed up significantly to produce opposite effects including anxiety, jumpiness, insomnia, and rapid heart rate.
Certain types of withdrawal syndromes come with greater life-threatening risks and complications than others, especially those associated with alcohol, benzodiazepines, and opioids. Withdrawing from alcohol and benzodiazepines can lead to grand mal seizures, while withdrawing from opioids can lead to dehydration and severe drug cravings that increase the risk of relapse and drug overdose. Fortunately, you can often avoid severe withdrawal symptoms and potential complications by receiving professional treatment at a drug and alcohol rehab center.
What Causes Drug and Alcohol Withdrawal?
Using drugs and alcohol in high amounts on a consistent basis for a period of time can cause physical dependence and withdrawal symptoms when abruptly discontinuing use. Withdrawal doesn’t always happen to everyone, but the risk increases the longer you use drugs and alcohol.
It’s important to know that drug and alcohol withdrawal syndrome isn’t linked exclusively to substance abuse or illicit drug use. For example, many prescription drugs are habit-forming. As a result, they can lead to physical dependence when used for longer than a few weeks, including painkillers (e.g., oxycodone, hydrocodone, morphine), benzodiazepines (e.g., alprazolam, clonazepam, lorazepam), and ADHD medications (e.g., Adderall, Ritalin, Concerta).
If you are using any of these medications, it’s important to ask your doctor how long they intend to keep you on these drugs. Another question to ask is how they plan on treating you for dependence and withdrawal when it’s time to discontinue your medication.
Withdrawal syndrome for many habit-forming prescription drugs is usually treated using a tapering schedule, which involves working closely with your doctor to reduce your dosage gradually over time and reduce the severity of symptoms and complications. In some cases, your doctor may refer you to a drug rehab center to withdraw from your medication under the supervision of trained professionals who specialize in addiction treatment.
Who Is Affected By Drug and Alcohol Withdrawal?
Anyone who uses alcohol and habit-forming substances regularly for a period of time can be affected by withdrawal regardless of age, socioeconomic status, and whether those substances are illicit or legally prescribed. It helps to familiarize yourself with withdrawal symptoms if you or a loved one is using one or more habit-forming substances to seek professional treatment if necessary.
It also helps to know common signs of addiction, which affect many who suffer from drug and alcohol dependence. Addiction is not the same as physical dependence, though it often happens at the same time. Addiction is characterized by a set of specific behaviors, rather than physical symptoms. It’s possible to be addicted to a substance without being physically dependent, and vice versa.
According to the National Institute on Drug Abuse, signs of addiction include:
- Using the substance in larger amounts than usual, or over a longer period than was initially intended.
- Having a persistent desire to reduce or control the use of the substance, but being unable to do so.
- Spending lots of time trying to obtain the substance, using the substance, and recovering from the effects of the substance (such as recovering from a hangover after heavy alcohol use).
- Experiencing strong cravings, urges, and desires to use the substance.
- Continuing to use the substance even when it interferes with important obligations related to work, school, and home, as well as your relationships and social life.
- Reducing time spent engaging in important social, recreational, and work-related activities on behalf of drug and alcohol use.
- Continuing to use the substance even in situations when it is physically hazardous to do so, such as driving to work every day while intoxicated.
- Continuing to use the substance despite knowing it is causing or worsening physical or psychological health problems.
- Having a higher tolerance for the substance, which is characterized by needing higher amounts to feel desired effects or experiencing diminished effects when using the usual amount.
- Experiencing withdrawal symptoms when abruptly discontinuing the substance, or continuing to use the substance for the sake of avoiding or relieving withdrawal symptoms.
If you or a loved one is experiencing at least two of the above criteria, it’s highly possible you or your loved one may need treatment for drug and alcohol withdrawal.
How Long Does Withdrawal Typically Last?
The withdrawal timeline is different for each person based on factors including the types of substances used, health status, metabolism, and the length of time they were using drugs and alcohol.
Here are withdrawal timelines by substance, according to the World Health Organization.
Opioid withdrawal produces symptoms that are highly similar to those of the flu. Common symptoms include nausea, vomiting, insomnia, diarrhea, and muscle cramps.
Withdrawal symptoms caused by short-acting opioids like heroin begin within eight to 24 hours after the last use and continue for between four and 10 days. Withdrawal caused by long-acting opioids like methadone typically begins within 12 to 48 hours after the last use and continues for 10 to 20 days.
Withdrawal symptoms caused by short-acting benzodiazepines like alprazolam and temazepam begin within one to two days after the last dose and continue for a minimum of two to four weeks. Withdrawal from long-acting benzodiazepines like diazepam typically begins two to seven days after the last dose and continues for a minimum of two to eight weeks. Common withdrawal symptoms include insomnia, anxiety, agitation, muscle aches, and poor concentration.
Stimulants (Cocaine, Methamphetamine, ADHD Medications)
Withdrawal symptoms caused by stimulants typically begin within one day of the last use and continue for three to five days. Withdrawal from ADHD medications may take longer and last for several weeks. Doctors usually use the tapering method to help patients safely discontinue these medications, according to research published in Innovations in Clinical Neuroscience. Common withdrawal symptoms of stimulants include muscle aches, depression, increased appetite, and irritability.
Withdrawal symptoms caused by alcohol usually begin within six to 24 hours after the last drink and continue for between two and 10 days. Symptoms usually peak in severity at between 36 to 72 hours, then gradually lessen in severity for the remainder of the withdrawal period. Nausea, vomiting, diarrhea, excess sweating, and tremors are some of the many common alcohol withdrawal symptoms.
Withdrawal symptoms caused by marijuana usually begin within 48 hours after the last use, according to a study published in Substance Abuse and Rehabilitation. Symptoms from marijuana are usually mild and last for between one and two weeks. Anxiety, restlessness, irritability, night sweats, and gastrointestinal problems are common symptoms of marijuana withdrawal.
How Can Drug and Alcohol Withdrawal Be Safely Treated?
Medical detox is the safest treatment for drug and alcohol withdrawal. This treatment may also be known as medication-assisted detox, medically assisted detox, or drug and alcohol detox. Medical detox is typically offered by recovery centers that specialize in addiction and drug and alcohol dependence.
Medical detox treatments take place in comfortable residential settings where patients can be closely monitored by nurses and doctors as they go through withdrawal. In some instances, patients may live at home as they go through withdrawal, especially if they are put on tapering schedules over a period of weeks, such as with benzodiazepine withdrawal.
However, patients who suffer from both addiction and dependence are usually encouraged to participate in a residential drug rehab program so they can receive behavioral therapy for addiction while gradually tapering off their medications.
Medications are usually used in detox to reduce withdrawal symptoms and help patients feel more comfortable. Medications can also prevent complications—such as seizures—that are related to certain withdrawal syndromes. Patients receive nutritional supplements that help strengthen and boost their immune systems. Additionally, patients are encouraged to drink plenty of water to replenish fluids lost through symptoms including sweating, vomiting, and diarrhea.
The medical team at an addiction treatment center will develop a customized detox program for you based on your unique situation. Your withdrawal timeline may be shorter or longer than expected based on your symptoms and on how you respond to treatment.
Regardless of your situation, the nurses and doctors overseeing your drug and alcohol detox treatment will take the necessary steps to keep you safe and to make you feel as comfortable as possible during your recovery.