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Article Summary

What Are Drug Withdrawal Symptoms?

While researching answers to the "what are drug withdrawal symptoms?" question, it is important that you understand that these symptoms, as well as their duration, will vary largely based on the substances you have been abusing as well as how long you have been addicted.

Consider the following examples of drug withdrawal symptoms as well as the timelines for several major substances of abuse:

  • Alcohol: Seizures and tremors that last anywhere between 3 days and several weeks
  • Benzodiazepines: Seizures and/or anxiety that can last for several weeks or months (in some cases)
  • Cocaine: Restlessness and depression that lasts for 7 to 10 days
  • Prescription painkillers and heroin: Flu-like drug withdrawal symptoms that last anywhere between 24 and 48 hours

Understanding Drug Withdrawal Symptoms

According to the NSDUH (or the National Survey on Drug Use and Health) for 2011, more than 25 million people in the United States aged 12 years and older - which is close to 10% of all Americans within this age group - had used illegal drugs within the month just prior to the survey. As such, these statistics classified these Americans as current substance abusers.

Apart from the above statistics, numerous research studies have shown that alcohol and addictive drugs change the way the human brain regulates mood and processes information. Most of these changes involve the creation of floods of neurotransmitters (like serotonin and dopamine). These floods, on the other hand, can create artificial feelings of intense euphoria and pleasure - commonly referred to as the high that many addicts seek when they abuse these substances.

If you continue abusing alcohol and drugs, the act can interfere with the reward and motivation circuitry and chemistry of the brain. In the long run, this could result in tolerance, dependence, and intense cravings for your preferred substances of abuse.

After you become dependent on a drug, it is highly likely that you will display drug withdrawal symptoms if you remove the substance from the equation by quitting your ongoing substance abuse or by reducing the dose that you have become accustomed to taking.

Even so, different substances and drugs come with a variety of drug withdrawal symptoms and different timelines. In many cases, these will depend on the interaction of these substances with your bodily functions and brain.

When you take drugs, they will be absorbed into your brain where they will remain active for various periods of time. In addiction and drug abuse studies, this is commonly referred to as the half-life of a drug. The half-life, on the other hand, will affect the different timelines of withdrawal for every substance that can be abused and cause addiction.

On the other hand, the duration and severity of your withdrawal will largely be influenced by how dependent you are, as well as on many other factors such as:

  • The existence of other medical factors
  • Mental health factors
  • The amount of the drug you took every time you abused it
  • The duration of time you have been abusing the drug
  • The mode of use or method of abuse, such as swallowing, injecting, smoking, or snorting
  • The types of drugs you have been abusing
  • Your family history
  • Your genetic makeup

For instance, if you have been injecting relatively high doses of heroin on a regular basis for several years and you have underlying mental health problems as well as a family history of substance abuse and addiction, it is highly likely that your withdrawal symptoms will last longer. You may also experience more powerful drug withdrawal symptoms than somebody who only abused smaller doses of heroin for a limited time period.

Consider the following overview of some commonly abused substances and their respective withdrawal symptoms and timelines

a) Alcohol

The National Library of Medicine has explained that alcohol withdrawal usually starts between 8 hours to several days after your last drink. After that, they will peak within 24 to 72 hours. They may also last for a couple of weeks.

b) Benzodiazepines

The Comprehensive Handbook of Drug and Alcohol Addiction reports that the withdrawal symptoms for Benzodiazepines - including Ativan, Klonopin, Valium, and Xanax - start within 1 to 4 days and peak within the first fortnight. However, the withdrawal can be protracted in some instances and end up lasting for several months (or even years) if you do not receive the right form of treatment and rehabilitation.

c) Cocaine

For cocaine, withdrawal may start within a couple of hours of your last dose of the drug. These drug withdrawal symptoms will peak within a couple of days and last anywhere from 1 to 10 weeks.

d) Heroin

According to NIDA (common abbreviation for the National Institute on Drug Abuse), heroin withdrawal tends to start within 12 hours of your last dose of the drug; the withdrawal symptoms of this drug, on the other hand, will peak in about 24 to 48 hours and end up lasting for a week to several months.

e) Prescription Opiates

According to the Cambridge Health Alliance, the withdrawal symptoms for most prescription opiates - like morphine, methadone, OxyContin, and Vicodin - will start in about 8 to 12 hours after your last dose. These symptoms will peak in 24 to 48 hours and end up lasting anywhere between 5 and 10 days. However, methadone withdrawal may start within 24 to 48 hours of your last dose and peak within the first couple of days before lasting for 2 to 4 weeks.

Drug Withdrawal Timelines For Common Substances Of Abuse

Apart from the above short explanation of examples of common drug withdrawal symptoms and timelines, consider the following comprehensive information relating to different drugs of abuse and their resultant withdrawal timelines:

1. Opiates And Heroin

Most opioid drugs of abuse can increase your feelings of euphoria and pleasure. However, at the same time, they are effective at numbing any pain sensations that you might be feeling.

Common examples of drugs within this category of substances include methadone, Percocet (acetaminophen and oxycodone), codeine, morphine, Vicodin (acetaminophen and hydrocodone), and OxyContin (or oxycodone).

Today, opiate drugs are ranked among the most addictive of all substances of abuse. In fact, SAMHSA (or the Substance Abuse and Mental Health Services Administration) reported in 2013 that more than 517,000 Americans could be classified as active abusers of heroin. The same report also showed that about 1.8 more people in the country were suffering from an active opioid use disorder that involved prescription painkillers.

But what can you expect from opioid drug withdrawal symptoms? Essentially, most of these withdrawal episodes will produce both psychological symptoms and physical symptoms that are similar to the flu.

These symptoms also come in the form of two distinct phases - commonly classified as early opioid withdrawal and late opioid withdrawal. During the first stage of withdrawal, you may experience:

  • Agitation
  • Anxiety
  • Insomnia
  • Muscle aches
  • A runny nose
  • Sweating
  • Tearing
  • Yawning

However, the late stage of withdrawal will usually give rise to the following symptoms:

  • Abdominal cramps
  • Chills
  • Diarrhea
  • Dilated pupils
  • Goosebumps
  • Nausea
  • Vomiting

According to Mayo Clinic, heroin comes with the shortest half-life of all opiates. This means that it will take effect faster than all other opiates but also leave your body faster.

To better explain this phenomenon, consider the case of OxyContin that has a half-life of anywhere between 3 and 4 hours (for the immediate-release form of this drug) and 12 hours for its extended-release form. Morphine, on the other hand, comes with a half-life of anywhere between 6 and 10 hours. This is according to the Clinical and Translational Oncology journal.

For all drugs, you will start feeling the withdrawal symptoms after the half-life of the drug has expired. During this time, the drug will not be active in your bloodstream anymore.

Although opioid withdrawal is not considered to be exactly life-threatening in the technical sense of the term, it can still prove dangerous. As such, you should only perform it under medical guidance, care, and supervision.

2. Benzodiazepines

Also referred to as benzos, benzodiazepines are a class of common prescription drugs that are primarily used in the treatment of seizures, panic disorders, and anxiety. These drugs are also used as muscle relaxants and sleeping aids.

As a class of drugs, benzodiazepines are considered to work by depressing the CNS (or the central nervous system). By so doing, they can dampen the fight or flight reflex - which tends to be hyperactive in people who are suffering from high levels of stress and anxiety. Additionally, these drugs activate the GABA (or gamma-amino-butyric acid) neuron that acts to sedate the body naturally.

If your brain becomes dependent on benzodiazepines and you suddenly remove the drug from the equation, you are highly likely to suffer rebound effects in the form of benzodiazepine withdrawal symptoms.

This happens because your brain may be trying to regain some form of balance after the sudden drop in the level of GABA neurons in the system. This opens the door to potentially higher levels of insomnia and anxiety during the earlier stages of your withdrawal.

However, most of the remaining withdrawal symptoms will occur over the acute phase of withdrawal and may include, but are not always limited to:

  • Anxiety
  • Difficulty concentrating
  • Disturbed sleep
  • Headaches
  • Heart palpitations
  • Hypertension
  • Irregular heart rate
  • Irritability
  • Muscle pain
  • Muscle stiffness
  • Nausea
  • Panic attacks
  • Short-term memory loss
  • Sweating
  • Tension
  • Tremors

In some cases, benzo withdrawal may also be accompanied by other serious side effects, including:

  • Delirium
  • Extreme confusion
  • Fever
  • Hallucinations
  • Seizures

Withdrawing from benzodiazepines is sometimes life-threatening. This is largely on account of the grand mal seizures that you may experience - which could potentially result in coma or sudden death. However, this usually happens for people who are heavily dependent on this class of drugs.

The psychological withdrawal symptoms, as well as the anxiety, are likely to continue for a couple of months (or even some years). According to ABC News, this happens for close to 10% of everyone who has developed tolerance, dependence, and addiction to benzos. This is commonly referred to as protracted withdrawal, and it is best managed through the receipt of mental health services and other forms of therapy and counseling.

That said, benzos are generally classified as long-acting, intermediate-acting, and short-acting. All of these drugs come with different half-lives - which will dictate the timeline of withdrawal.

Short-acting benzodiazepines, for instance, tend to come with the shortest half-life. This means that the withdrawal will start faster for these drugs than for long-acting benzos.

Examples of short-acting benzos include Serax (or oxazepam) and Halcion (or triazolam). Intermediate-acting benzodiazepines, on the other hand, include Xanax (or alprazolam) and Ativan (lorazepam). Last but not least, examples of long-acting benzos include Librium (or chlordiazepoxide), Klonopin (or clonazepam), and Valium (or diazepam).

All of these types of benzodiazepines, however, are the same in the sense that they can produce near-similar withdrawal symptoms. As such, it is essential that you only undergo medically managed detoxification.

3. Cocaine

Cocaine is a stimulant drug that comes with a relatively short half-life - of less than about a hour. This means that cocaine tends to take effect quite quickly, but it also leaves the bloodstream relatively rapidly.

As a stimulant drug, cocaine works to elevate blood pressure, body temperature, and heart rate. When you are high on this drug, it can produce elevated self-confidence, heightened energy levels, and extreme euphoria. However, these feelings and effects will not last long. As a result, most people are likely to end up abusing cocaine repeatedly and in binge patterns.

Today, cocaine comes in two main forms. First, there is the powdered form of the drug that people inject, snort, and smoke. Second, you can buy crack cocaine - the rock form of the drug - that most people prefer to smoke.

Irrespective of the form of the drug you take, the DEA (or the Drug Enforcement Administration) reports that injecting or smoking cocaine can send the drug straight into your brain. As a result, these modes of administration are likely to result in higher highs (or pleasurable effects) and quicker crashes.

If you are addicted to cocaine, and you stop taking it - or reduce the dose that you have become accustomed to - it is highly likely that you will suffer intense withdrawal symptoms.

In many cases, cocaine withdrawal usually manifests itself over 3 distinctive phases. These include the initial crash, a period of acute withdrawal, and the extinction period. Read on to learn more:

a) Crash Period

For most people, the crash from cocaine abuse and addiction tends to last anywhere between 9 hours and 4 days. According to the NHTSA (or the National Highway Traffic Safety Administration), the symptoms that you may experience and display during a cocaine crash are usually related to the opposite effects of the stimulation that the drug causes.

As such, while undergoing the crash phase, you may find yourself sleeping for several days. It is also highly likely that this period could lead to an increase in your levels of appetite, agitation, and depression.

b) Acute Withdrawal

Once you progress to acute cocaine withdrawal, the phase may last for 1 to 3 weeks. It is commonly symptomized by intense drug cravings, anxiety, insomnia, depression, fatigue, and irritability.

c) Extinction Period

During this phase, it is highly likely that you may experience intense cravings for the drug alongside depression. The withdrawal symptoms could also encompass the development of suicidal ideation (or suicidal thoughts). This period usually lasts for several months after you stop abusing cocaine.

Withdrawing from stimulants like cocaine is like any other form of drug withdrawal. This is because of the general lack of most physical symptoms. To this end, cocaine withdrawal is not usually considered life-threatening in nature.

For most addicts, the emotional turmoil and drug cravings can be treated by working with mental health professionals who are trained to deal with drug addiction and dependence. This way, you will receive the psychological care and support you need during the initial cocaine detoxification period as well as throughout your ongoing recovery.

4. Alcohol

The NCADD (abbreviation for the National Council on Alcoholism and Drug Dependence) reports that alcohol is perhaps the most commonly used and abused substance all over the United States. In fact, the problem of alcohol abuse is so expansive that almost 1 out of every 12 American adults continue battling alcohol issues and dependency problems on an annual basis.

Withdrawal from alcohol for most of these people comes with a variety of side effects. These include coma and death to more mild symptoms that are similar to a hangover from alcohol.

However, the longer and more you engage in patterns of excessive alcohol consumption, the more likely it is that your brain might develop a dependence on the substance. This might also lead to even more serious withdrawal symptoms when you start detoxing from the substance.

The NEJM (abbreviation for the New England Journal of Medicine) reports that close to 50% of everyone with an AUD (or an alcohol use disorder) will end up undergoing alcohol withdrawal when they reduce their drinking or cut it out altogether.

In the same way, anywhere from 3 to 5% of these people end up suffering the most serious type of alcohol withdrawal - also known as DTs or delirium tremens. During this form of withdrawal, they may experience:

  • Agitation
  • Delirium
  • Fever
  • Hallucinations
  • Seizures
  • Severe confusion

All of these symptoms may prove fatal unless the alcoholic receives swift and immediate medical intervention. Additional alcohol withdrawal symptoms include but are not limited to:

  • Anxiety
  • Clammy skin
  • Dehydration
  • Depression
  • Dizziness
  • Elevated heart rate
  • Fatigue
  • A headache
  • Insomnia
  • Irritability
  • Loss of appetite
  • Loss of color (especially in the face)
  • Mood swings
  • Muscle aches
  • Nausea
  • Nightmares
  • Problems thinking clearly
  • Shakiness
  • Shallow breathing
  • Sweating
  • Tremors
  • Trouble concentrating
  • Vomiting

For most people, alcohol withdrawal tends to be most intensely felt within the first couple of days. The physical effects, however, will start tapering off within a couple of days to about a week. Even so, the cravings for alcohol as well as the emotional and psychological effects are likely to continue for much longer.

Although you may start withdrawing from alcohol within a couple of hours after your last drink, it is highly unlikely that you will experience delirium tremens (if at all it comes) for several days after. In many cases, in fact, delirium tremens tends to appear quite suddenly. As a direct result, it is safe that you undergo through this form of substance withdrawal under the care, management, and monitoring of a medical professional - which should happen around the clock.

More On Drug Withdrawal Symptoms

Addiction tends to come with devastating negative effects on those who are affected directly as well as their families, friends, and colleagues. Sadly, the problem continues affecting a significant portion of the American population - making it a national epidemic.

Even so, it also means that people who undergo withdrawal should receive the benefit of support from their families. Through this support, it is highly likely that they will feel more motivated and encouraged to battle their withdrawal symptoms and come out stronger and more resistant to their preferred substances of abuse.

Among the negative aspects of ongoing addiction is that it can lead to withdrawal symptoms. The fear of these symptoms as well as the threat that it is highly likely for you to experience them might stop you from quitting drugs once and for all.

This is why it is essential that you consider medical addiction treatment - which is a requirement if your withdrawal symptoms are to be properly and professionally managed. Through such treatment, you can overcome these symptoms, most of which tend to be unpleasant, unbearable, and - quite often - dangerous and fatal.

But what are some of the withdrawal symptoms that you are likely to suffer? Consider the following examples:

  • A heightened positive or negative emotional state
  • Achy muscles
  • Anxiety
  • Attempts at testing your personal boundaries
  • Being difficult to deal with
  • Body aches
  • Cold flashes
  • Constipation
  • Crawling in the skin
  • Depression
  • Despondence
  • Diarrhea
  • Digestion problems
  • Drastic changes in body temperature
  • Dry mouth
  • Emotional instability
  • Fear about things
  • Feeling irritable
  • Feeling unable to perform some of the most basic motor functions
  • Feelings of concern
  • Flu-like symptoms
  • Frustration
  • General muscular discomfort
  • Headaches
  • Hot flashes
  • Increased appetite
  • Increased sensitivity to pain
  • Insomnia
  • Intense temptations to start using drugs again
  • Irritability
  • Lack of appetite
  • Lack of coordination
  • Loneliness
  • Losing one's temper
  • Mood swings
  • Muscle spasms
  • Nervousness
  • Paranoia
  • Physical discomfort
  • Raging feelings
  • Restlessness
  • Shaking
  • Stomach pains
  • Strong cravings for drugs
  • Sudden gain in appetite
  • Sudden loss of appetite
  • Sudden weight gain
  • Sudden weight loss
  • Sweating
  • Total emotional breakdown
  • Total mental agitation
  • Tremors
  • Twitching muscles
  • Using as a result of social pressure
  • Violence
  • Vomiting
  • Weakness
  • Wooziness
  • Worthlessness about self and about the future

Inpatient Treatment For Drug Withdrawal

Although most of the above symptoms - if not all of them - do sound grim, it is imperative that you remember that you can overcome and totally vanquish them. After that, you should be able to go on and lead a lifestyle of health, sobriety, and recovery away from drugs of abuse.

The best way to do this would be to check into an inpatient drug addiction treatment and rehabilitation facility. This way, you will receive the recovery option to help you find your way to stability and freedom from ongoing substance use.

Recovery through these forms of treatments will also provide you with the most effective approach to treating alcohol and drug addiction. In many cases, these treatments tend to be comfortable enough to ensure that the addicts who are in the program are successful in overcoming their drug dependence and addiction.

In many cases, inpatient treatment will start with a full detoxification program. This way, it will work on all the unpleasant, uncomfortable, and - potentially - dangerous and fatal symptoms of drug withdrawal.

Additionally, the program might also provide you with rehabilitative therapy and counseling to ensure that you continue maintaining your sobriety and recovery in the long term.

Managing Drug Withdrawal

Irrespective of whether you have developed an addiction to alcohol or drugs, it is imperative that you deal with the withdrawal symptoms that are likely to arise when you quit or reduce your normal dose of these intoxicating and mind-altering substances.

However, such withdrawal tends to be difficult for most people. This is because of the symptoms of withdrawal - which are highly uncomfortable and sometimes dangerous. If you are unsuccessful in overcoming these symptoms, it is highly likely that you may relapse and start using drugs again.

This is why you need to cope with any cravings you might feel for your favorite substances of abuse. In many cases, this will require you to learn and adopt new healthy habits. Through these habits, you can effective circumnavigate all your attention from substance abuse to new and healthier ways of living.

In case you have ever relapsed once, or several times before, you might not understand the fact that these feelings never tend to last forever or even for long - at least for many addicts.

In particular, you may want to remember that getting over and above the first couple of days to several weeks of drug withdrawal tends to be the hardest aspect of detoxification and addiction treatment.

Coping Strategies

Even with addiction treatment and detoxification, you can be sure that not all treatment options and coping mechanism work universally for everyone who is addicted and dependent on drugs.

In fact, everyone who is fighting their addiction has a different reason for using and a different form of substance use disorder. As a direct result, you can rest assured that not all treatment options will work equally effectively for everyone.

To this end, if you try something and it does not work, you should always try another strategy. In the long run, you can only achieve ongoing sobriety for the rest of your life if you are committed to full abstinence.

You may, therefore, want to understand the various reasons why you may have started using and abusing drugs as well as those that kept you abusing these intoxicating and mind-altering substances. This understanding could potentially provide you with answers that could help you identify the most effective coping strategies and approaches that will work well for you.

Examples of effective coping strategies for dealing with withdrawal symptoms and addiction include:

a) Physical Activities

You may want to try activities like yoga and exercises - because they have been proved to be effective in helping addicts keep their minds and thoughts off drugs. Most people who smoke tobacco cigarettes, for instance, are afraid that they will gain weight if they quit. However, exercising a couple of times every week could negate this fear and enable you to quit earlier.

b) Support Systems

The support of your friends, family, and counseling groups like Alcoholics Anonymous and Narcotics Anonymous can all encourage you to quit. Talk to people about your cravings and quell your desire to start using drugs.

c) Preparation

Last but not least, you might want to prepare yourself for what will happen when you quit. In particular, get answers to the "what are drug withdrawal symptoms?" question so that you are aware of what you should expect from ongoing recovery and quitting. Understanding your expectations during detoxification and withdrawal can help you create an effective action plan. Later, you can use this plan to encourage yourself to continue battling your addiction - particularly during the usually uncomfortable and sometimes dangerous period of withdrawal.

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