Nausea and Vomiting From Drug Withdrawal

Unless you go through a very gradual tapering process, usually under medical supervision, withdrawal symptoms are a normal and expected part of coming off alcohol and drugs. Two common withdrawal symptoms are nausea (a feeling of sickness in the stomach) and vomiting.

Withdrawal nausea and vomiting are uncomfortable and unpleasant symptoms that occur among people who have been addicted to some drugs, particularly alcohol and opiates, or even after a period of intense substance use. Symptoms may range from mild to severe.

In addition to nausea and vomiting, people with alcohol withdrawal syndrome may also experience:

• Tremors
• Headaches
• Rapid heartbeat
• Irritability
• Insomnia
• High blood pressure
• Confusion

These symptoms often become gradually worse in the first two to three days after the last time alcohol was consumed. Symptoms of nausea can begin approximately six to 12 hours after the last drink. Vomiting may then follow during the first 12 to 24 hours.

The following strategies can help control withdrawal nausea and vomiting:

• Pepto-Bismol (bismuth subcarbonate) may help ease withdrawal nausea and vomiting.
• Acupuncture can help relieve withdrawal nausea and vomiting symptoms. If you can't get an acupuncturist to visit, you can stimulate the point associated with relieving nausea by pressing or gently massaging the area on your wrist about two inches down from the crease at the base of your hand, just between the tendons. This point is called pericardium 6, or P6 for short.
• One of the main risks with vomiting is dehydration, so get plenty of water or other clear drinks.
• Fluid loss is not the only problem with dehydration; you also risk the loss of electrolytes, particularly if you also have diarrhea. Drinking rehydration fluid, which is available from drug stores, can help you avoid this. You can also add one teaspoon of sugar and one teaspoon of salt to two liters of water to make up your own inexpensive rehydration fluid.
• You may prefer to avoid food intake until the initial acute withdrawal phase has passed, although for some drugs, such as opiates, this may last several days to a week. When you feel able to eat, choose bland foods, such as white toast, white rice, and bananas, and avoid spicy foods.

Remember, although nausea and vomiting are a normal part of withdrawal, if nausea or vomiting symptoms continue, they could indicate another underlying condition such as pregnancy, food poisoning, migraine headaches or peptic ulcer.

The wear and tear caused by repeated vomiting may result in vomiting blood. However, blood in your vomit could indicate a very serious medical condition. Therefore, if you see any blood in your vomit at any time, you should seek medical attention immediately.

Alcohol withdrawal can also cause other symptoms, including:

• Depression
• Anxiety
• Nightmares
• Mood swings
• Fatigue
• Jitteriness
• Clouded thinking
• Clammy skin
• Sleeping problems
• Tremor
• Appetite loss
• Paleness
• Sweating

As with nausea and vomiting, if these symptoms don't go away after you have stopped using alcohol or drugs for a week or so, they could indicate another medical condition, and you should see a doctor.

Ongoing feelings of depression or anxiety, or severe, uncontrollable mood swings may indicate that you have another mental disorder that may require treatment.

Particularly if alcohol use has been severe and prolonged, a more severe, and potentially deadly, form of alcohol withdrawal can occur called delirium tremens. Symptoms usually start 48-96 hours after your last drink and may include:

• Fear
• Confusion
• Agitation
• Problems focusing
• Mood swings
• Hallucinations
• Delirium
• Fever
• Changes in blood pressure
• Rapid heart rate

Talk to your doctor if you have developed a dependence on alcohol and want to stop drinking. Your doctor can offer advice on treatment options and supervise your withdrawal. Appropriate treatment is essential for overcoming alcohol use disorder. Medications such as lorazepam (Atvian), clonazepam (Klonopin), and alprazolam (Xanax) can help you manage the symptoms of alcohol withdrawal syndrome. Psychotherapy and support groups can also be helpful for supporting long-term recovery.