The Complete Guide to Drug & Alcohol Withdrawal
Withdrawing from drugs and alcohol can be a challenging process, yet it is one of the most important steps you can take to rebuild your health and well-being. Withdrawal occurs when people who abuse drugs or alcohol develop physical dependence to these substances. Their bodies have adapted to the presence of the drug and come to “need” it to function and feel normal.
When people who have developed significant levels of dependence stop using, they may experience withdrawal. In association with different types of substance dependence, sudden abstinence (or even decreased use, in some instances) may give rise to a variety of challenging withdrawal symptoms. Symptoms can be unpleasant, uncomfortable, or even life-threatening.
If you or someone you love are struggling with addiction you may have questions such as, ‘what is withdrawal?’ or ‘how long does withdrawal last?’—keep reading to learn more about how to get help for dealing with withdrawal symptoms.
Discuss with Your Physician and Seek Professional Help
Professional withdrawal treatment benefits many people going through the withdrawal process. Before starting detox, you should speak with your physician or other treatment professional about what type of withdrawal management you might need. They will examine your history of drug or alcohol abuse, history of previous withdrawal, and general physical and psychological health, including whether you have any co-occurring mental health disorders.
For many people, a period of supervised medical detox takes place at the start of additional recovery efforts. While not all substances are associated with significantly unpleasant, complicated, or potentially dangerous withdrawal syndromes, professional detox can help make the entire process as safe and comfortable as possible for all types of withdrawal.
For some individuals, having expert supervision, guidance, and monitoring during alcohol or drug withdrawal can facilitate what might otherwise be an overly-challenging hurdle in the way of long-term recovery. In addition to a supportive and encouraging environment, treatment professionals at detox centers will be able to address any medical or psychiatric issues that may arise as a result of withdrawal and provide you with medication, if necessary, to help ease any troublesome symptoms (withdrawal or otherwise) that you may experience.
When is Medical Detox Necessary?
In certain cases, medical detox is necessary to minimize the risk of potentially life-threatening withdrawal symptoms like seizures. Marked agitation, delirium, and seizures may occur in association with withdrawal from substances like alcohol, benzodiazepines, or other sedative-hypnotic drugs. Potentially severe, relapse-prompting withdrawal is also a significant risk for people with pronounced opioid dependence.
In the interest of safety and humanitarian concerns, medical detox or some form of 24-hour care may be advised for people who have a history of severe or complicated withdrawal, have had multiple withdrawal experiences, or are at risk of alcohol, sedative-hypnotic, and/or opioid withdrawal.1 Even if these conditions don’t apply to you, 24-hour care can be helpful if you have been using any substance for a long time, do not have a supportive or stable home environment, or might otherwise be at high risk of immediate relapse.
Common Symptoms of Withdrawal
Commonly-encountered symptoms of withdrawal can vary according to the substance used, how long it was used, your age, and certain unique physiological, genetic, and psychological characteristics. Withdrawal symptoms can range in intensity from mild to severe and can have varying durations. In general, some of the more commonly seen substance withdrawal symptoms include:2
- Insomnia or sleep disturbances.
- Mood swings.
- Muscle aches and pains.
Different drugs are associated with their own characteristic withdrawal symptoms. For example, chronic opioid use may lead to withdrawal symptoms like tachycardia (fast pulse), increased respiratory rate, fever, vomiting, and diarrhea. While these symptoms can be very unpleasant and uncomfortable, they are not typically life-threatening. They may, however, be so intense that relapse becomes an immediate concern.
Timelines for withdrawal may also vary by substance and your unique physical, physiological, and genetic factors. For example, heroin withdrawal symptoms may first arise 8-12 hours after the last dose and resolve within 3-5 days, while withdrawal associated with a longer-acting opioid like methadone might not start until 36-48 hours after the last dose and take up to 3 weeks (or longer) to resolve.1
Alcohol Withdrawal Symptoms
Alcohol use disorders and problematic drinking—such as binge episodes—are alarmingly prevalent, yet many are unaware of the health dangers associated not only with drinking itself, but with attempts to quit drinking. While some alcohol withdrawal symptoms are merely uncomfortable, some can be lethal. As with most substances, the severity and duration of symptoms can vary based on your length of alcohol abuse, whether you have experienced previous complicated withdrawal, as well as other mental and medical health factors. For many, symptoms start as soon as 6 hours after the last drink, with the risks of certain severe symptoms such as seizures lasting for several days.
Because of the risks, many undergo alcohol detox in a supervised medical setting. When the risks of withdrawal complications are significantly high—such as those of grand mal seizures and delirium tremens—inpatient medical withdrawal management may be necessary during alcohol detox.1
Additional symptoms of acute alcohol withdrawal may include:1, 3, 5, 6
- Appetite loss.
- Cognitive impairment (i.e., not thinking clearly, problems remembering things, difficulty with work performance).
- Trouble sleeping.
- Rapid heart rate.
- Sweating or clammy skin.
- Tremors in your hands or other body parts.
- Delirium tremens, a troubling development that can include seizures, hallucinations, fever, agitation, and severe confusion. This is condition requires immediate medical attention.
- Seizures, which generally occur within the first 48 hours of withdrawal. Seizures can happen to anyone going through alcohol withdrawal, though they may be more likely in people who have experienced previous withdrawal episodes or in people who abruptly stop drinking after consistent and heavy alcohol use.
When severe, alcohol withdrawal can be life-threatening. However, medical detox and withdrawal management can help to keep people safe and prevent complications from arising.
Benzodiazepine Withdrawal Symptoms
As both have central nervous system
depressant pharmacologic activity, the acute benzodiazepine withdrawal syndrome
shares some of the same symptoms that commonly arise during alcohol withdrawal.
Benzodiazepine withdrawal symptoms include:7
- Tension, anxiety, and panic attacks.
- Sleep disturbances.
- Difficulty concentrating.
- Heart palpitations.
- Muscle aches and pains.
- Hand tremors.
Though there may be a relatively lower risk than that associated with alcohol, seizures are possible with benzodiazepine withdrawal. Similarly, people may also experience delirium, which is one of the more severe symptoms of benzodiazepine withdrawal. As with alcohol withdrawal, the supervision and care of a medical detox can help to keep people safe during benzodiazepine withdrawal and, in general, increase the level of comfort during what might otherwise be an extremely difficult-to-endure period of time. Protocols for medical management may include a slow tapering of the benzodiazepine previously taken or a substitution of a longer-acting benzodiazepine agent prior to initiating a tapered dose schedule. 1
Benzodiazepine withdrawal can be extremely challenging for those in recovery. When people withdraw from benzodiazepines, they commonly experience a short period of intense withdrawal anxiety and insomnia that may last for 1-4 days after stopping the medication (depending on the half-life of the specific substance). However, some people may experience a more prolonged and severe withdrawal with more intense symptoms that can last between 10 and 14 days. Still others may experience persistent anxiety symptoms that continue until they receive some form of treatment.7
Is Someone You Love Struggling with Withdrawal?
Are you or someone you love struggling with quitting drugs or alcohol?Are the symptoms of withdrawal too much to handle or making it tough to move forward with your recovery efforts? Are you wondering how to cope with withdrawal anxiety or symptoms? You are not alone. It can be difficult to see someone you care about struggling with addiction. Even though you want to provide the best help and support possible, you might not be sure where to start.
Many people who have struggled with addiction and stopped using drugs or alcohol have gone through withdrawal. Know that help is available, and with the proper detox and withdrawal management, you or your loved one can safely and comfortably navigate withdrawal from drugs and alcohol, regain control of your life, and begin the road to recovery. Going through detox is the first step in this process. While detox should not be viewed as a substitute for additional rehabilitation, it will help clear the substance from your body so that you’ll be better focused on your recovery work.
American Addiction Centers Can Help
At American Addiction Centers (AAC), we are committed to providing safe and effective medical detox and addiction treatment. American Addiction Centers has helped thousands of people reclaim their lives from addiction and lead healthier, happier lives in recovery. Across our Joint Commission certified facilities in eight states, we offer:
- Safe medical detox at all AAC inpatient treatment facilities.
- Easy access to facilities across the United States. Whether you’re attending treatment locally or out-of-state, there’s an American Addiction Centers facility that can be convenient for you.
- A confidential helpline dedicated to helping people find treatment for themselves or loved ones. We have caring and professional staff who know how to best guide you through the process of finding appropriate treatment geared specifically for your needs. Our admissions navigators are available 24/7 to discuss your concerns and provide support when you don’t know where to turn.
Still Unsure About Seeking Treatment?
Even if you’re still not sure about asking for help, know that there’s no commitment when you call our helpline.
We’re happy to provide information about withdrawal, detox, treatment, and the ways we can help you achieve recovery.
Consider this guide that explains exactly what calling a substance abuse helpline as well as this guide outlining the typical steps to sobriety.
1. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
2. Health Direct. (2018). Addiction withdrawal symptoms.
3. MedlinePlus. (2019). Alcohol withdrawal.
4. American Liver Foundation. (2017). Alcohol-related liver disease: Facts at a glance.
5. Rogawski M. A. (2005). Update on the neurobiology of alcohol withdrawal seizures. Epilepsy Currents, 5(6), 225–230.
6. National Institute on Alcohol Abuse and Alcoholism. (2001). Alcohol alert: Cognitive impairment and recovery from alcoholism.
7. Petursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455-1459.