Drug withdrawal takes place when a person who has been using a particular substance long enough and in sufficient quantities to develop a dependency upon the drug – be that physical, psychological, or both – stops using the drug. Withdrawal is the process of that person’s system readjusting to the absence of the substance; during that period of readjustment, a variety of (usually unpleasant) symptoms may manifest, which together are known as withdrawal symptoms or withdrawal syndrome.
Withdrawal varies in terms of its effects and duration depending on a number of factors, including the age and physiology of the addict, the type of drug being consumed, the duration of the addiction, the dosages being consumed, the method of consumption and more.
Withdrawal lasts until the addict’s system has completely readjusted to life without the substance in question – in cases of psychological addiction, this can mean many months or even years after the last dose, though usually withdrawal will be complete within one or two weeks.
What Is Psychological Withdrawal?
Psychological withdrawal occurs when someone is addicted to a drug which is not necessarily physically addictive, but upon which they have become psychologically dependent. This means that they will consume the drug despite knowing that to do so as detrimental effects upon their life; and that they will think obsessively about procuring and consuming the drug constantly. The drug will dominate their daily lives and may well have very negative long-term consequences for their mental health.
Psychological withdrawal tends not to result in physical withdrawal symptoms (although many addicts do display psychosomatic symptoms); instead, psychological symptoms are likely to manifest which may include constant cravings, insomnia, mood swings, and depression and more.
Because psychological addiction cannot simply be “broken” in the same way as physical addiction through detoxification, it often lasts much longer than the latter and psychological withdrawal symptoms – especially depression – can persist for months or even years, while addicts can feel cravings on a sporadic basis for many years and even, possibly, for the rest of their lives.
Therapy is invariably needed to overcome deep-seated psychological addiction and can be invaluable in the fight against relapse, as the drive to give into temptation is psychological in nature.
What Is Physical Withdrawal?
Physical withdrawal occurs when someone has become physically dependent upon a substance. This means that the parts of the brain responsible for regulating certain bodily functions have become reliant upon the presence of that drug in the system, and require that drug to function normally.
When the drug is withdrawn from the system (i.e. when the user stops taking the drug) the aforementioned parts of the brain enter a period of abnormal function for the period of withdrawal (i.e. until the addict’s system has readjusted to the absence of the drug) and a number of physical symptoms of that abnormal behaviour may manifest.
As noted above, some substances – especially alcohol and benzodiazepines – are so physically addictive that withdrawal from them can be fatal without the correct medical attention. Other substances – notoriously opiates including heroin and many prescription drugs – are unlikely to pose a risk of death during withdrawal but can create intensely unpleasant and painful withdrawal symptoms which have been known to drive the addicts in question to suicide.
Physical withdrawal tends to last between one week and a fortnight depending on various factors; symptoms fade away once the user’s body has become accustomed once again to the absence of the drug.
Which drugs cause withdrawal symptoms?
Effectively, any addictive drug can lead to withdrawal symptoms upon cessation of use: if someone has become psychologically dependent on a substance, they will almost certainly experience some kind of withdrawal once they stop taking it. Withdrawal symptoms are not only a factor in the case of addiction to illegal drugs: prescription medication, although used therapeutically, may also be addictive.
Likewise, legal recreational substances including alcohol – as noted above, one of the most dangerous substances in terms of its withdrawal – can also cause withdrawal symptoms. In other words, the legal status of the substance is irrelevant when it comes to whether or not it poses a danger of withdrawal symptoms.
Opiates, stimulants and similar
Opiates and opioids – including heroin, morphine, and a variety of prescription medicines are highly physically addictive as well as causing psychological dependency, and withdrawal symptoms are notoriously unpleasant and frequently painful; they may include stomach cramps, nausea, vomiting, and fever and other flulike symptoms, muscle cramps and spasms, sweating, urinary problems, diarrhoea, headaches, restlessness, and irritability.
Addicts frequently resort to relapsing during withdrawal even if they are determined to overcome their addiction, simply because of the severity of physical symptoms of withdrawal.
Some of these symptoms can be dangerous or even – in the case of certain drugs including alcohol and benzodiazepines – fatal; moreover, withdrawal symptoms can be so unpleasant that some addicts suffer suicidal ideation whilst going through them. Here are some of the most often witnessed symptoms of withdrawal:
Is Withdrawal Dangerous?
As noted above, withdrawal can be extremely dangerous and even fatal without the correct medical attention. In terms of physical dependency, addicts – especially long-term addicts – can become so reliant upon their substance of abuse to function normally that their systems can malfunction in dangerous ways including the possible manifestation of seizures, which can prove fatal, and high body temperature and blood pressure which can lead to organ failure.
In the case of alcohol and benzodiazepines, sudden cessation of use is strongly advised against as the sudden absence of those substances in the system can cause fatal reactions. Even in cases where withdrawal is not directly fatal, the addict going through withdrawal can experience such negative sensations and emotions that they can be driven to self-harm or even suicide.
Moreover, the consequences of withdrawal can be such that the risk of accidents is greatly increased, while especially volatile behaviour – potentially leading to violence and associated dangers – is not uncommon. Because of this, going through withdrawal independently without the correct medical advice and assistance is strongly advised against, and it is especially vital that no one goes through withdrawal from any substance alone.
How long does withdrawal last?
Generally speaking, withdrawal from physical dependency will last between one and two weeks (though in cases of severe and long-lasting addiction, it may take significantly longer – and it is important to remember that long-term abuse of certain substances can cause permanent damage to the health of the addict, with symptoms which may resemble those of withdrawal but which will not fade over time).
Symptoms will peak after two or three days and may plateau for several days, but will usually begin to decline by the second week and in most cases the majority of symptoms will have faded by the end of a fortnight.
Tends to have longer lasting withdrawal symptoms associated with it. Sleep patterns can be disturbed for weeks, or even months, while disorders such as depression can also persist for significantly longer than a fortnight. If symptoms persist for much longer than that period, the addict has almost certainly developed post-acute withdrawal syndrome (PAWS), a long-term condition which usually requires significant therapy to combat.
Moreover, cravings – a fundamental aspect of withdrawal and one which can lead to relapse without proper psychological precautions being taken – can recur for many months and even years after the last dose,
What Is Drug Detox?
Many people confuse detox and rehabilitation: detox is a fundamental aspect of rehabilitation, but they are not the same thing. Detox refers only to the process of cleansing the system of substances of abuse, and is invariably undergone as the first phase of any residential rehabilitation “rehab” before an addict moves on into therapy.
Meanwhile, rehabilitation is a holistic long-term process aimed at ensuring that once you have gone through detox and are clean of all substances of abuse, you do not give in to any temptation to relapse and can continue living a drug-free life.
What are the different types of drug detox?
There are various different types of drug detox, although the general principle – that the addict refrains from using their substance of abuse until all traces of it have left their system – remains the same.
Residential detox involves going through detox and withdrawal in a dedicated rehab facility (usually prior to moving into further phases of rehab involving therapy and more).
Home detox is the process of going through detox in a home environment, almost always without constant medical attention (indeed frequently without any medical help at all).
Medically assisted detox describes the process of going through detoxification with the help of certain drugs which can ameliorate the worst symptoms of withdrawal and in some cases perform other tasks such as substituting for substance of abuse on a temporary basis.
Is home detox safe?
Many people prefer to attempt detox and withdrawal by themselves, either because of the shame and stigma attached to drug addiction and an unwillingness to discuss their problems with anyone else, even their doctors; or because they are worried about the potential difficulty or cost of obtaining treatment elsewhere.
However, home detox can be extremely dangerous and tragically large number of people die each year whilst attempting to detox by themselves in their home environment because they do not have the right protections and assistance to keep them safe during the process. Going through detox and withdrawal without medical assistance is strongly advised against by the medical community.
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The dangers of home detox
There are many dangers associated with home detox. Firstly, as noted above withdrawal from some substances can be fatal by itself: a heavy addiction to alcohol or benzodiazepines especially can result in fatal seizures and/or organ failure if the addict suddenly ceases their substance abuse (and in certain cases withdrawal from other drugs can also prove fatal for similar reasons).
Without medical assistance being on hand, an addict going through withdrawal who begins to exhibit dangerous signs (which may not be immediately recognisable as dangerous by the layperson) is at risk of dying as a result of lack of treatment.
Even in cases where withdrawal itself is not fatal, its effects can be so traumatic as to drive the withdrawing addict into self-harm or even suicide (this can be a long-term phenomenon, with depression persisting long after cessation of use and resulting in suicide ideation for a very broad range of possible reasons).
Moreover, many addicts who relapse during the detox process die as a result of taking the dosages to which they were previously accustomed, but which their systems are now unable to tolerate after a period of detox and withdrawal. This can also be avoided with the correct therapeutic assistance, which is very unlikely to be available in the home environment.
What Is a Medically Assisted Detox?
A medically assisted detox is the process of going through detoxification with the help of certain medicines that can make the process of withdrawal more bearable. This can mean treating some of the symptoms of withdrawal with medicine – for example, using hypnotics to help with insomnia – but can also mean weaning the addict off their substance abuse with the help of a substitute drug.
Many long-term addicts benefit greatly from this substitution process as it reduces the impact of the initial shock of cessation of use and allows for the manifestation of much less severe withdrawal symptoms, which tend to decline significantly more quickly than those associated with the initial substance of abuse.
Which drugs are used for a medically assisted detox?
The drugs used in a medically assisted detox will depend on the substance of abuse in question, and the nature of the withdrawal symptoms which the addict is experiencing. For example, antidepressants may be prescribed to counter depression (especially in the case of long-term withdrawal or post-acute withdrawal syndrome), while as noted above hypnotics can be prescribed to counter insomnia.
In the case of weaning and substitution, heroin addicts may be provided with methadone or buprenorphine/naloxone (which are opioids similar to heroin but which have lighter effects and are associated with less severe withdrawal symptoms) while benzodiazepines are often prescribed to counter alcohol withdrawal.
It is vital to note that many of the drugs used in medically assisted detox are themselves potentially habit-forming and should only ever be administered by experienced medical professionals for a limited time: no addict should ever attempt to engage in a medically assisted detox independently as doing so could be fatal.
What Are the Benefits of a Drug Detox?
For any addict, a drug detox can be literally life-changing. First and foremost it will break the immediate cycle of dependency and abuse which will dominate an addict’s life; although withdrawal can be extremely unpleasant, it is not intolerable and once on the other side, free from the immediate pressures of your system’s demand for your substance of abuse, you will feel a huge weight lifted from your shoulders and will be able to approach the next phase of recovery without your days being dominated by procuring drugs and becoming intoxicated
In the simplest terms, nobody can live a drug-free life until they first stop taking drugs – and detox represents that crucial first step of freeing yourself from the immediate need to take drugs to feel “normal”.
What Happens after Detox?
What happens after detox depends upon the circumstances in which an addict has gone through detox. At rehab, detox is only the first phase of a holistic treatment program with which the addict will be provided for the duration of his or her stay.
The next phase is a combination of therapies – both one-to-one and group – during which the addict will address the root causes of addiction in order to understand the steps that they took previously which led to that condition, and how to avoid repeating them, and will be equipped with defence mechanisms to protect them against the temptation to relapse.
They will also enjoy the benefits of a bespoke fitness and dietary plan in order for them to have the most robust footing possible in terms of physical as well as mental health on which to approach their recovery.
How long an addict will stay in rehab will very much depend on individual circumstances, but usually a stay of 30 days is typical. However recovery does not finish wants a person leaves rehab: it is a constant process which may well involve various setbacks, and attendance at fellowship groups – at which a recovering addict can find support and advice from people who have been through the addiction process – is recommended for everyone who has been through addiction recovery and wishes to continue to lead a life free of substance abuse.
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Frequently Asked Questions
How long does withdrawal last?
The precise duration of withdrawal will depend on various factors such as the physiology of the addict, the substance of abuse, the dosages consumed and the methods of consumption. Generally speaking withdrawal will last between one and two weeks, with symptoms peaking after two or three days; however some symptoms may persist for much longer.
What can I expect from physical withdrawal?
Physical withdrawal from a substance of abuse is usually accompanied by nausea and vomiting; insomnia; restlessness; agitation; muscle cramps and spasms; diarrhoea and other digestive problems; flulike symptoms including fever, sore throat, and runny nose; sweating; shivering; aggression; mood swings; and depression. Every case is unique and some addicts may experience few or none of the above; however most are likely to have at least some at some stage of withdrawal.
What is psychological withdrawal?
Psychological withdrawal is the process of readjusting mentally to a life without drugs (specifically from the substance of abuse to which you have become addicted). Psychological withdrawal symptoms often include insomnia; paranoia; mood swings; depression; aggression; irritability; and nightmares. In extreme cases psychosis may also manifest.
When is detox necessary?
Detox is necessary whenever someone has become dependent – either psychologically or physically – upon a substance of abuse and wishes to stop taking that substance permanently. It is a necessary preparatory step for later phases of recovery including therapy.
Which medications are used during detox?
The medications used during medically assisted detox will depend upon the substance of abuse and the nature of the withdrawal symptoms being experienced. Antidepressants may be prescribed for depression; hypnotics and sedatives may address insomnia, mood swings and aggression; benzodiazepines may be given as antianxiety medication and also to address dangerous symptoms of withdrawal from alcohol; meanwhile some opioids such as methadone and buprenorphine/naloxone may be given as a substitute for heroin or other stronger and more addictive opioids. Other drugs may be prescribed on a case-by-case basis.
What are the most common drug withdrawal symptoms?
Withdrawal symptoms differ from one case to another but the most common include insomnia; paranoia; mood swings; depression; aggression; irritability; nightmares; nausea and vomiting; restlessness; agitation; muscle cramps and spasms; diarrhoea and other digestive problems; flulike symptoms including fever, sore throat, and runny nose; sweating; shivering; and psychosis.
How long does a drug detox last for?
Every case of addiction and withdrawal is unique, and people experience withdrawal symptoms differently and for varying lengths of time. Typically, detox will last between one and two weeks with most symptoms declining in the second week until the addict’s system is free of substances of abuse. In some cases post-acute withdrawal syndrome may develop which may require long-term therapy.
Is it possible to complete a home drug detox?
Various home drug detox options are available, especially marketed online; however it is strongly recommended never to go through detox and withdrawal without medical assistance as to do so can be fatal. Some home detox kits are not medically approved and may contain substances which may interact dangerously with your substance of abuse, or to which you may be allergic.
What are the benefits of a drug detox?
The benefits of a drug detox are to cleanse an addict’s system of substances of abuse so they no longer feel the immediate pressure from their own body and mind to consume drugs, and can move on to therapy as the next phase in a permanent recovery.
Can drug withdrawal cause seizures?
Yes: withdrawal from some substances – most notably alcohol and benzodiazepines – can cause seizures which can be fatal without medical assistance.