July 10th, 2020

What Is Alcohol and Drug Withdrawal?

A young man in a red shirt and dark pants is on a bathroom floor in a hook sitting position with his head down and eyes closed.

When alcohol or drug use becomes the focal point in someone’s life, they may neglect everything else including: their health, family obligations, work, hobbies. However, with US drug use on the rise and many overdose-related fatalities making headlines, it’s not uncommon for these individuals to assess their use of substances. At that point, they may decide to stop drinking or using drugs. But stopping is easier said than done.

When an individual uses alcohol or drugs heavily on a daily basis, their body struggles to regain its balance. They generally develop physical and psychological expectations centered around the substance — particularly in cases involving a substance use disorder. In such instances, the body’s natural state of homeostasis is disrupted. When that person ceases use of the substance, they may experience symptoms ranging from mild to severe. This process is known as withdrawal, and it reflects the body’s fight to find balance.

To learn more about the specifics of withdrawal, including its symptoms, duration, and treatment options, read on. This article will provide an in-depth look at withdrawal. It also provides advice for people who want to stop using drugs and/or alcohol.

Withdrawal symptoms

There are many signs that someone might be going through withdrawal. This condition typically results in some common symptoms:

  • Mental symptoms: Anxiety, irritability, depression, troubles with sleep, and problems concentrating
  • Physical symptoms: Headaches, disorientation, chest pains, heart palpitations, gastrointestinal problems, tremors and shakes, and excessive sweating

Beyond these, there are some extreme symptoms to be on the lookout for. Call 911 immediately if the person has hallucinations, seizures, a heart attack, a stroke, or the sudden onset of intense confusion.

Withdrawal symptoms vary from case to case. Each person’s body is unique, and different substances affect the body in different ways. So as the body seeks to return to normal, withdrawal symptoms will also vary. For example:

  • For alcohol withdrawal, symptoms include increased blood pressure and heart rate, nausea, vomiting, diarrhea, seizures, and delirium. Alcohol withdrawal affects most organ systems. In extreme cases, without medical intervention, withdrawal can lead to death.
  • For cocaine withdrawal, symptoms include sleeplessness (or extreme restlessness), an increased appetite, depression, paranoia, and decreased energy. Withdrawal can sometimes lead to severe depression, and thoughts of suicide.
  • For heroin withdrawal, symptoms including persistent craving, nausea, vomiting, and diarrhea are common, as are mild symptoms like a runny nose, teary eyes, and excessive yawning. It’s not uncommon for individuals experiencing heroin withdrawal symptoms to become dehydrated.
  • For marijuana withdrawal, symptoms include irritability, changes in dietary and sleep habits, nausea, problems concentrating, vision problems, and diarrhea.

While this isn’t a comprehensive list, it illustrates how symptoms can vary from substance to substance. If you or a loved one are experiencing unusual symptoms during withdrawal, talk with a doctor.

How long does withdrawal last?

Even when withdrawal effects are relatively mild, they can be physically and mentally draining. During withdrawal, many patients ask how long their symptoms will last. Remember that withdrawal symptoms can vary greatly depending on the individual and the substance they used. The duration of these effects also vary.

Using the examples discussed above, let’s review how acute withdrawal symptoms may last for specific substances:

  • For alcohol withdrawal, symptoms can last 5 to 7 days
  • For cocaine withdrawal, symptoms can last from 3 to 4 days
  • For heroin withdrawal, symptoms can last 4 to 7 days
  • For marijuana withdrawal, symptoms can last up to several weeks

These are general timeframes — note that it is difficult to predict how long withdrawal symptoms may persist. Even people who use the same substances, in the same way, can have entirely different withdrawal experiences.

Post-acute withdrawal syndrome

People who use a large amount of a substance or use it for a long period of time can have some additional problems during withdrawal. As their acute withdrawal symptoms subside, these patients can start to have post-acute withdrawal syndrome (PAWS). This term refers to the psychological and emotional impacts of withdrawal that persist long after the initial withdrawal phase.

Post-acute withdrawal syndrome can cause an individual to feel intense cravings, depression, mood swings, fatigue, insomnia, and cognitive impairments—long after cessation. These symptoms come as episodes lasting a few days each, and they can occur unexpectedly. When combined with the many potential causes for drug and alcohol addiction, PAWS puts individuals at ongoing risk for relapse for a couple of years following cessation.

Coping with PAWS requires recognizing triggers, a commitment to self-care, and exploring treatment options. This can help individuals recover and avoid relapse during this difficult time.

Withdrawal treatment options

Some people may be able to stop using substances and go through the entire withdrawal recovery process without medical intervention. However, this isn’t always the case; some may need medical assistance for withdrawals. There are a variety of withdrawal treatment options.

Medication-assisted treatments for withdrawal

Medication-assisted treatments are a common approach to managing withdrawal symptoms. These medications are intended to safely relieve physical symptoms and chemical imbalances that cause cravings. In cases involving dangerous symptoms, such medications can be life-saving.

Some FDA-approved medications can help in this regard. People with withdrawal symptoms should talk to a healthcare provider to explore their options.

Intensive outpatient treatment

Many patients who are working through withdrawal symptoms can successfully recover with intensive outpatient treatment. These programs are comprehensive and involve an evaluation process, a personalized treatment plan, and measurement of recovery progress. Because the patient doesn’t need to stay at a hospital or residential rehab center, the patient can continue completing day-to-day tasks while following treatment plan requirements.

Online outpatient treatments can be highly convenient and adaptable to patient needs. They can offer help in managing cravings and physical symptoms. If medical-assisted treatment is warranted, nurses can remotely organize prescriptions to be sent to pharmacies near the patient.

Inpatient treatment

Patients with severe substance use disorders, dangerous symptoms, or self-harm may need inpatient treatment. This involves a mandatory residency at a facility for anywhere from 28 days to several months. Making arrangements with your family and employer to accommodate for this period of time can be challenging, but as a last resort, it can be an effective method of preventing relapse without putting the patient at risk.

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