Withdrawal

Withdrawal symptoms set in when a person’s drug intake is lowered or halted. The withdrawal process brings on a variety of physical and psychological symptoms. These symptoms vary depending on the nature of the addiction. Fortunately, they can be managed through medications and supervision from doctors.

Withdrawal Overview

Withdrawal is a common side effect of addiction treatment. When a person with an addiction tries to limit or stop their drug use, they often experience symptoms of withdrawal.

Withdrawal can happen when someone with an addiction uses less of a drug or stops using it altogether. Because their bodies have grown accustomed to the abused drug, painful or violent reactions set in.

Withdrawal symptoms come in many forms depending on the person’s addiction and their overall health. In terms of addiction treatment, withdrawal symptoms typically make people uncomfortable. Fortunately, they are not usually dangerous. However, people who are severely addicted to a substance may experience life-threatening symptoms.

During the treatment process, withdrawal symptoms often occur during detox. Though they may be uncomfortable, patients in detox are monitored by their doctors and families to ensure their safety.

Most withdrawal symptoms last for a few days to a few weeks before subsiding. Patients can then move on to long-term rehabilitation through inpatient or outpatient rehab.

Types of Withdrawal

Symptoms of drug withdrawal typically affect a person’s mind and body. The reason for this is because addiction is a complex disease that affects a person’s mental and physical health. This combination separates withdrawal from illnesses with similar symptoms, like the common cold.

Many people suffering from addiction have both physical and psychological dependencies. Specific physical and psychological symptoms vary for different addictions and people. Withdrawal symptoms for various types of substances are detailed below.

Alcohol Withdrawal

Alcohol withdrawal symptoms depend on how severe the person’s addiction is. Those who drink heavily and for longer periods of time run the risk of more intense symptoms. What makes alcohol withdrawal more complex is that many different symptoms may appear during detox.

To make sure alcohol withdrawal does not pose a serious threat, an addiction specialist should be consulted. They can determine the best way to detox and limit the risk of life-threatening issues.

Symptoms of withdrawal usually start 6 hours after the person stops drinking and peak around 24-72 hours. They gradually resolve within a week’s time.  

Symptoms of alcohol withdrawal can either be minor or serious, with the more serious symptoms showing up if the addiction is more severe.

Minor alcohol withdrawal symptoms include:

  • Sweating
  • Anxiety
  • Nausea
  • Vomiting
  • Sleep disturbances
  • Headaches
  • Rapid heart rate

Serious alcohol withdrawal symptoms include:

  • Withdrawal Seizure Syndrome: The onset of seizures that occur within 24 to 48 hours of stopping alcohol use. They tend to come as a single seizure or a cluster of multiple seizures occurring close together.
  • Alcohol Hallucinosis: This involves the short-term problems with hallucinations which can be auditory, visual or tactile in nature. Besides the hallucinations, there are few other symptoms, as the person remains well oriented.
  • Delirium Tremens: This is a life-threatening reaction that may occur during alcohol withdrawal. It is a relatively uncommon symptom. However, those with delirium tremens will need up to 12 days to recover as its symptoms worsen before they improve. Symptoms of delirium tremens include:
    • Visual, auditory and sensory hallucinations
    • Confusion and disorientation
    • Agitation
    • Fever
    • High blood pressure

Cocaine Withdrawal

When not using cocaine, a person’s mental and physical functions decline. Cocaine withdrawal starts with a relatively rapid “crash” shortly after its last use.

Symptoms of cocaine withdrawal include:

  • Paranoia
  • Exhaustion and fatigue
  • Irritability
  • Insomnia
  • Depression and suicidal thoughts
  • Mood swings and anxiety
  • Intense drug cravings
  • Sensation of insects crawling under the skin

Though most of the physical symptoms fade, psychological withdrawal symptoms from cocaine can last for several months or years. Even after many of the physical effects of withdrawal have passed, there are often continued cravings for the drug. Stressful circumstances increase the craving risk. About one-third of patients that beat cocaine addiction will become addicted to other drugs at some point.

Heroin Withdrawal

Heroin withdrawal sets in very quickly after the last time the drug has been used. Its symptoms are not life-threatening, but they are very uncomfortable. Some of heroin’s withdrawal symptoms are similar to those found in other opiates.

Without supervision, people with heroin addictions are at high risk of relapse during withdrawal. In addition, withdrawal can be life-threatening if you are withdrawing from more than one drug aside from heroin.

There are two stages of withdrawal from heroin:

  • Stage 1: Sets in within 8 hours of using the drug for the last time. Its symptoms include:
    • Moodiness
    • Restlessness
    • Muscle cramps
    • Nasal congestion
    • Anxiety
    • Agitation
  • Stage 2: Sets in 8 to 24 hours after stopping the drug. Its symptoms include:
    • Dilated pupils
    • Nausea and vomiting
    • Extremely runny nose/eyes
    • Stomach cramps and diarrhea
    • Extreme drug cravings
    • Fever or chills
    • Increase in blood pressure and/or respiratory rate

The symptoms of withdrawal start about 12 hours after the last heroin use. They peak within 3 to 5 days. After the peak, the symptoms linger for up to two weeks. However, long-term withdrawal symptoms can last from months to years. These tend to be less uncomfortable than immediate symptoms, but they can still impact a person’s life.

Long-term heroin withdrawal symptoms include:

  • Poor concentration
  • Unstable sleep patterns
  • Variable energy
  • Anxiety
  • Decreased enthusiasm
  • Frequent mood swings

OxyContin Withdrawal

OxyContin is an extended-release tablet, so its effects will not wear off for 12 to 24 hours. Withdrawal symptoms can set in 4 to 8 hours after the last dose. Early symptoms last about a day before late symptoms develop.

There are two different stages of OxyContin withdrawal. Symptoms last up to two weeks after stopping the drug. They may be more severe because the drug is often taken in high doses.

Early symptoms of withdrawal include:

  • Mood changes (anxiety, agitation and restlessness)
  • Insomnia
  • Muscle aches
  • Cold/flu-like symptoms

Late-stage symptoms can include:

  • Nausea/vomiting
  • Diarrhea
  • Anorexia
  • Abdominal cramps
  • Blurry vision and dilated pupils
  • High blood pressure
  • Rapid heartbeat and shivering

While these are very uncomfortable feelings, they are not generally life-threatening. Drugs like clonidine and lofexidine will help with many of the physical symptoms associated with OxyContin withdrawal.

Physical withdrawal passes within two weeks, but psychological withdrawal can last for many months afterward. Medications for anxiety or depression can be used to ease psychological withdrawal symptoms.

Crystal Meth Withdrawal

Withdrawing from crystal meth comes with a variety of symptoms. While its physical symptoms are relatively mild, the psychological symptoms are very severe. The only time withdrawal from this drug is life-threatening is if the patient engages in self-harm due to powerful drug cravings.

Withdrawal symptoms begin within a day after stopping the drug and peak 7 to 10 days later. Symptoms gradually reduce after that. A complete withdrawal takes up to 20 days or less. A person withdrawing from crystal meth may need inpatient therapy if these symptoms put them in danger.

Common crystal meth withdrawal symptoms include:

  • Lethargy
  • Excessive fatigue and sleepiness
  • Dry mouth
  • Increased appetite
  • Feeling jittery

Severe symptoms include:

  • Depression and suicide attempts
  • Extreme drug cravings
  • Hallucinations
  • Paranoia

Withdrawal and Long-Term Recovery

Though withdrawal can be painful in the short-term, it is an essential part of addiction recovery. Thankfully, medicines can help manage the immediate effects of withdrawal. A closely monitored detox process can keep people safe from complications.

Once the immediate withdrawal process has been completed, patients can learn how to manage any long-term withdrawal symptoms in rehab facilities or programs. They will also get valuable advice on how to prevent relapses and live a drug-free life.

Author:Kent Hoffman
Kent Hoffman

Kent Hoffman, D.O. has been practicing medicine for nearly 30 years. He is board-certified to practice addiction medicine and family medicine. Dr. Hoffman gets to know his patients on a first-name basis to provide compassionate and professional health care.

Last modified: 01/14/2019