What Is Withdrawal?

Young woman suffering from withdrawal headache while sitting on the sofa at home with an expression of being unwell
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What Is Withdrawal?

Withdrawal is the combination of physical and mental effects that a person experiences after they stop using or reduce their intake of a substance such as alcohol and prescription or recreational drugs.

If you have been using a substance with a high potential for dependency and you stop suddenly or abruptly or you cut down your use drastically, you can experience a variety of withdrawal symptoms. The intensity and duration of these withdrawal symptoms can vary widely, depending on the type of drug and your biological make-up.

Withdrawal can be unpleasant and potentially dangerous in some cases. For this reason, you should always talk to your doctor before stopping or reducing your use of a substance.

Symptoms

Withdrawal symptoms vary depending on the type of drug you were taking. Some symptoms commonly associated with withdrawal include:

  • Changes in appetite
  • Changes in mood
  • Congestion
  • Fatigue
  • Irritability
  • Muscle pain
  • Nausea
  • Restlessness
  • Runny nose
  • Shakiness
  • Sleeping difficulties
  • Sweating
  • Tremors
  • Vomiting

More severe symptoms such as hallucinations, seizures, delirium may also occur in some instances. The type of drug you were taking, the amount of time you were taking it, and the dosage you were taking can all have an effect on the type and severity of the symptoms you experience.

While the physical symptoms of withdrawal might last only a few days or a week, the psychological withdrawal, such as depression or dysphoria, can last much longer.

Identifying Withdrawal

People may recognize symptoms of withdrawal when they stop taking or cut back on a substance. Missing your usual morning cup of coffee, for example, might result in symptoms of caffeine withdrawal such as fatigue, headache, and irritability.

Symptoms of withdrawal are an indication of dependence on a substance. You should talk to your doctor before you reduce or stop taking a medication or drug for advice on how to do so safely and minimize potential withdrawal symptoms. Your doctor may be able to help if you are having trouble managing your symptoms and provide medical supervision to ensure your safety as you detox from a substance. 

Your doctor will also be able to determine if the symptoms you are experiencing are due to withdrawal or if they are the result of another condition.

Causes

The body and brain work to maintain a state of balance known as homeostasis. Taking a substance changes that balance, so your body has to take steps to adjust including changing the levels of certain neurotransmitters. These substances act on your brain's reward system, triggering the release of chemicals.

When you regularly take a substance for a period of time, your body may build a tolerance and dependence on that substance. Tolerance means that it takes larger doses of the substance to achieve the same effects that you initially experienced, while dependence means that your body requires the substance in order to avoid experiencing withdrawal effects.

If you abruptly stop or decrease your intake of the substance, your body is once again thrown off balance and symptoms of withdrawal may result. Such symptoms are often both physical and mental, and can potentially be dangerous depending on the type of drug.

Withdrawal symptoms are often the opposite of the effects of the substance. For example, alcohol is a depressant, so if you suddenly stop consuming alcohol, you might experience symptoms of overstimulation such as anxiety or restlessness.

Types

The specific withdrawal symptoms you experience depends on the type of drug you were taking. There are a number of different drug types that can result in withdrawal, including the following:

  • Antidepressants
  • Barbiturates
  • Cannabis
  • Depressants
  • Hallucinogens
  • Inhalants
  • Opioids
  • Stimulants

The following are some examples of specific substances that may lead to withdrawal and the expected duration of those symptoms:

  • Alcohol: Not everyone who stops drinking alcohol has withdrawal symptoms, but most people who quit suddenly after drinking enough alcohol for any length of time can experience a wide range of symptoms. Many times those symptoms will trigger a relapse.
  • Heroin: Those who have become addicted to heroin experience some particularly intense withdrawal symptoms, but even the worst of those symptoms will subside in five to seven days. However, for some, post-acute withdrawal syndrome (PAWS) can last for weeks or even months.
  • Marijuana: Compared to alcohol and other drugs, the withdrawal symptoms some marijuana users experience when they try to quit are on the mild side. But, some of those symptoms are unpleasant enough for some that they decide to go back to using the drug.
  • Nicotine: Not everyone experiences all of the same symptoms of nicotine withdrawal. As many who smoke know, symptom of nicotine withdrawal can make it difficult to give up cigarettes. There are steps you can take to reduce those symptoms, too.
  • OxyContin (oxycodone): The severity of OxyContin and other prescription opioid withdrawal symptoms is usually related to how long you have taken the medication and how much you took. If you took the painkiller only as directed, you may not experience any withdrawal symptoms at all, or very mild ones.

Treatment

Treatment for withdrawal includes support, care, and medications that can ease symptoms and prevent possible complications.

With some substances, people are able to stop their use abruptly and manage their withdrawal symptoms on their own. For example, a person may be able to quit caffeine without assistance and cope with the unpleasant symptoms on their own until they pass.

But abruptly quitting substances such as benzodiazepines or alcohol can be potentially dangerous, so always consult your doctor to come up with a detox plan. Medically-assisted withdrawal can ensure that you are safe and help to minimize unpleasant withdrawal symptoms.

Withdrawal Medications

The medications your doctor may prescribe to help alleviate symptoms of withdrawal will vary depending on the type of substance you were taking. Some medications that are used to treat various types of withdrawal include:

  • Catapres (clonidine)
  • Librium (chlordiazepoxide)
  • Buprenex (buprenorphine)
  • Valium (diazepam)
  • Ativan (lorazepam)
  • Methadone

Other medications may also be used to manage specific withdrawal symptoms. These may include anti-anxiety medications, anticonvulsants, antipsychotics, or other drugs designed to treat nausea or sleep problems.

According to the National Institute on Drug Abuse, in most cases, the symptoms associated with drug withdrawal are easily treated with medications that reduce or eliminate the discomfort. But, treating withdrawal is not the same as treating the dependence or addiction itself.

Coping

In addition to seeking medical support, there are also things that you can do that may help you feel better as you go through the withdrawal process:

  • Ask for help. Whether you are handling withdrawal on your own or under the supervision of a doctor, it is important to have social support. Tell a trusted friend or family member so that they can check-in and support you during the process.
  • Eat well. Focus on eating nutritious, well-balanced meals. Eating fried, fatty, or sugary foods may make you feel worse.
  • Exercise. Try to get some physical activity each day. Stretching, walking, swimming, or other activities may help boost your mood.
  • Drink plenty of water. It is important to stay hydrated as you are going through withdrawal, especially if you are experiencing flu-like symptoms such as nausea and vomiting.
  • Relieve symptoms with over the counter (OTC) medications. Use appropriate OTC medications at the recommended dosages if you are experiencing symptoms such as headache, upset stomach, or diarrhea.
  • Sleep. While withdrawal can sometimes lead to sleeping difficulties, try to get an adequate amount of rest. Work to establish a regular sleep schedule and practice good sleep habits.

Stress management activities such as yoga and meditation may also help you cope with your withdrawal experience. Be sure to reach out to your doctor, however, if you are struggling to cope or if you experience any worrisome symptoms.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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Article Sources
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