In a result-driven society like ours, the pressure of deadlines, raising a family, and trying to find time for your mental wellbeing is often enough to succumb to chemical temptations. Although turning to drugs or alcohol to cope with the rigors of life isn’t healthy, it’s understandable when a person feels no other options exist.
However, that glass of wine after dinner may turn to two or three or a whole bottle as time goes on. The small dose of Xanax your doctor prescribed seems fine because it was given by a doctor and doubles as time goes on, or the opioids you use recreationally on the weekend become a daily habit you can’t shake. Either way, drug and alcohol use starts somewhere, and addiction can eventually ruin the lives we worked so hard to build.
Prolonged use of drugs or alcohol will lead to tolerance, which is when a person needs to take more of the substance to experience the effects they once felt. Over time, this will lead to a chemical dependency that leads to withdrawal symptoms upon cessation. While drugs like marijuana produce mild withdrawal symptoms, alcohol, benzodiazepines, and barbiturates can produce fatal outcomes. You might wonder about the prevalence of illicit drug use and alcohol consumption in our society and how it affects the people around us.
According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 11.7 percent of those over 12 had used any illicit drug in the past month. Another two percent of those over the age of 12 also reported nonmedical use of a psychotherapeutic drug in the past month.
Despite its legality, alcohol is considered one of the most deadly drugs in existence, which is a terrifying statement considering how widely available the substance is and how heavily it’s advertised. Not only is alcohol dangerous by itself, but using it in conjunction with other central nervous system (CNS) depressants can be fatal. With that said, 85.6 percent of people over the age of 18 admitted to drinking at some point in their lifetime, while another 69.5 percent reported drinking in the past year. An estimated 54.9 percent reported drinking in the past month.
An emerging trend is called high-intensity drinking, which is defined as consuming alcohol at levels two or more times the gender-specific binge drinking thresholds. Compared with those who don’t binge drink, individuals who drank alcohol at twice the gender-specific binge drinking thresholds were nearly 70 times more likely to have an alcohol-related emergency room (ER) visit. Those who consumed alcohol are three times the gender-specific thresholds were up to 93 times more likely to end up in the emergency room.
From alcohol, benzos, marijuana, and other drugs available to the public, none have left their mark like opioids. In 2019 alone, around 50,000 people died from overdoses in the United States. This was caused by prescription opioids like hydrocodone and oxycodone, as well as illicit opioids like heroin or fentanyl.
What causes this? What is the reason that a person who is addicted to drugs or alcohol will act out of character and steal from family members to support their habit? Although it’s not a single answer, one significant characteristic that fuels the drug and alcohol issues in our world is the withdrawal symptoms they face. Drug and alcohol withdrawal is a significant barrier to a person getting sober. So, what exactly is withdrawal?
What Is Drug Withdrawal?
When a person uses drugs or drinks alcohol for a prolonged or repeated basis, their brain starts adjusting to the presence of the substance. Introducing foreign chemicals to the body will initially cause it to fight against the substance. However, over time, the person will acclimate to its presence and will become physiologically dependent on the substance. Unfortunately, their bodies will also become utterly reliant on them to function or feel “normal.”
When a person develops a significant tolerance, withdrawal is an inevitable response to the abrupt cessation of a drug’s declining concentration in the system. Withdrawal symptoms are even more likely to develop when someone stops using drugs “cold turkey,” which is when they halt use at once without tapering safely. This will occur even when reducing the dose, but symptoms are likely to be less severe.
During withdrawal, our bodies strive to reach a new state of homeostasis as the drug or alcohol exits our system. It can result in a vast fluctuation of brain chemicals and accompany significant physical and mental health repercussions. For example, when a person consumes benzodiazepines over a prolonged period, the body stops naturally producing gamma-aminobutyric acid (GABA) and relies on the drug. When you stop, your body needs time to start producing its own GABA. This is why seizures can occur during benzo withdrawal.
As was mentioned above, drug and alcohol withdrawal isn’t just a few days of uncomfortable symptoms that eventually pass. It’s much more than that — these mental, physical, and emotional symptoms can be hazardous to your health without seeking the proper care. Although detox might not be necessary for marijuana use, it could be the difference between life or death with other drugs.
How Long Does Withdrawal Last?
It’s challenging to offer a definitive answer when it comes to drug and alcohol withdrawal. There are so many factors that influence withdrawal, such as the type of substance used and the severity of their dependence. In some cases, withdrawal can last days, weeks, or even months to reach a complete resolution of their withdrawal symptoms. Again, this is wholly dependent upon individual differences and some of the factors we discussed previously.
Drug Withdrawal Timelines
Below we’ll provide a general overview of specific drugs and their characteristic withdrawal timeline:
- Short-Acting Opioids: Short-acting opioids include certain prescription drugs and heroin, and the withdrawal symptoms typically start eight to 12 hours after the last use. On average, these last anywhere from four to ten days. The severity of symptoms will depend on the size of the individual’s last dose.
- Longer-Acting Opioids: Longer-acting opioids like methadone, commonly used to treat opioid addiction & withdrawal, are associated with prolonged withdrawal periods. It may take two to four days before withdrawal symptoms appear and will last up to ten days or more, depending on how much is used and for how long.
- Benzodiazepines: The most commonly prescribed benzodiazepines include Klonopin, Clonazepam, Xanax, Valium, and Ativan. Doctors prescribe these medications to treat anxiety, insomnia, and seizure disorders. Withdrawal from benzos starts within one to four days after the last use and will peak in severity during the first two weeks. However, in some cases, protracted withdrawal can last for months or even years without the proper treatment.
- Alcohol: Alcohol withdrawal symptoms can show up within several hours after the last drink and peak around 24-48 hours after. The risk for seizures is most prevalent anywhere from 12 to 48 hours later. Other severe conditions, like delirium tremens (DTs), remain a concern for as long as three days after the individual’s last drink. When it comes to alcohol withdrawal, you should seek emergency medical attention to avoid anything serious.
The duration and severity of withdrawal from substance dependence are based upon several factors, including how much of the drug or alcohol someone was using at a time and how often they used it. Unfortunately, withdrawal is a profoundly uncomfortable experience that can either stall or complicate recovery efforts. As was mentioned above, it’s a significant barrier to getting help. Unmanaged withdrawal can be dangerous and often requires medical care to keep a person safe during this period.
Continued abuse of alcohol or drugs will interfere with a person’s motivation and reward chemistry and circuitry, which results in dependence and drug cravings. Detoxing from a single substance will result in various withdrawal symptoms and health risks that evolve over different time frames compared to another type of drug. With that said, some withdrawal symptoms will yield more discomfort rather than dangers, while others are severe and can cause death.
Using other drugs in conjunction with your drug of choice also complicates efforts. Not only do you run the risk of withdrawal from one drug, but you can also experience many different withdrawal symptoms from both drugs. The stress on your body alone is enough to push someone to relapse.
With that said, medical detox is a common step in the earliest stages of recovery. A team of doctors, nurses, and other addiction specialists will help manage the individual’s withdrawal process to mitigate the risk of dangerous symptoms or withdrawal complications and alleviate their discomfort with medication. Withdrawal can be unpredictable, and surrounding yourself with experts is the best choice you can make.
Heroin & Opiate Withdrawal
Heroin is an opioid drug, and opioids work in our body by attaching to and activating opioid receptors located throughout the body. When opioid receptors are activated, it’s associated with a release of dopamine in the brain, reinforcing the continued use of opioids for their desirable effects. Opioids are among the most widely abused and highly addictive classes of drugs. Some degree of opioid dependence can develop even after short periods of use, even when used as prescribed by a doctor.
Opioid medications are meant to be used under the supervision of medical professionals. They were synthesized to alleviate physical pain caused by illness, injury, or following surgery. However, misuse of these medications can significantly increase the chances of someone becoming physiologically dependent on them.
Acute opioid withdrawal syndrome involves several characteristics that include the following:
- Frequent yawning
- Anxiety or nervousness
- Inability to sleep (Insomnia)
- Cold-like symptoms
- Flu-like symptoms
- Cold or hot flashes
- Excessive sweating that can lead to dehydration
- Runny nose
- Body aches or muscle cramps
Opioid withdrawal is rarely tied to life-threatening complications. However, that doesn’t mean they don’t occur. As was mentioned above, withdrawal from any substance is unpredictable, meaning freak symptoms could appear. The most common opioid withdrawal symptom is the distress those trying to get sober will face. The mere discomfort that some describe as mimicking the flu can lead to immense psychological and physical pain. Without the proper care, opioid withdrawal can drive someone toward relapsing, which will derail their recovery attempt(s).
Benzodiazepines, otherwise referred to as “benzos,” are a class of medications that treat panic disorder, anxiety, and specific types of seizure disorders. Doctors might also prescribe the drug for off-label uses like tremors or muscle spasms. When used as prescribed, they can adequately treat these symptoms and help a person return to their routine. However, they can be dangerous when abused. As central nervous system depressants that affect GABA, withdrawal symptoms have the potential to be severe.
The most common benzos include:
Despite their ability to manage panic, anxiety, and other conditions, the euphoria produced by benzos can lead to misuse and developing a dependence on them. If you’re using benzos and wish to stop, consult the prescribing physician to weigh your options and find a healthy exit.
Cocaine is an extremely addictive stimulant drug that influences the reward center in our brain. It does this by blocking the removal of dopamine from the synapses. This reinforced cocaine use lays the framework for potential compulsive patterns of use, driving physiological dependence on the substance.
Abrupt cessation of cocaine can lead to a severe rebound effect in the individual’s mood. A user who’s dependent on cocaine will likely experience withdrawal symptoms within the first day of their last use, and the withdrawal symptoms can last for weeks before they experience a semblance of normalcy.
Although cocaine withdrawal is seldom physically dangerous, it can cause other distressing psychological symptoms that include the following:
- Psychotic episodes
- Depressed mood
- Ongoing lethargy or feeling tired
- Thought of self-harm
Stimulant withdrawal is much different than withdrawal from other substances because it lacks many physical symptoms. Because of this, cocaine withdrawal is typically not viewed as life-threatening. However, it can lead to suicidal thoughts, meaning you should be monitored for psychiatric episodes during this time. If you experience thoughts of self-harm, please call for help.
Although alcohol isn’t regarded as a drug, it’s the most prevalently consumed addictive substance in the country. Those with alcohol dependence are at risk of severe withdrawals and should never attempt to stop using “cold turkey” due to the increased likelihood of seizures or other withdrawal-associated complications. For a majority of those who experience alcohol withdrawal, it’s uncomfortable, but in some cases, it’s life-threatening if not managed through proper channels such as medical detox.
Like opioids and benzodiazepines, alcohol is also a central nervous system depressant. Abrupt cessation or slowed use after the development of dependence will likely result in dangerous nervous system excitation as your body restores equilibrium. Alcohol withdrawal symptoms can appear within hours of the last drink, and if you’re dependent on the substance, you might experience some of the following symptoms if you quit.
- Nausea or vomiting
- Delirium tremens (DTs)
It’s challenging to predict who’s at the highest risk of developing severe withdrawal symptoms and complications. However, the likelihood of experiencing significant symptoms will increase with the frequency of drinking and average quantity consumed. Those with a history of polydrug use, certain medical issues, and those who have dealt with previous episodes of alcohol withdrawal are at additional risk.
Although alcohol withdrawal can occur within the first few hours after your last drink, delirium tremens won’t develop for a few days after and will appear suddenly, which makes it crucial to be monitored around-the-clock by a medical professional in detox.
When Is Drug Detox Necessary?
There are a specific set of factors to consider when someone decides whether or not to seek medical detox to manage their withdrawal symptoms.
As we’ve uncovered, withdrawal is a challenging and often dangerous time for someone planning to get sober. If you’re planning on a sober future, you should seek an addiction expert’s guidance, who will likely recommend medical detox. By doing so, once the withdrawal symptoms appear, they will be adequately managed by trained medical staff. Since it’s unpredictable, surrounding yourself with specialists will minimize any of the risks. Withdrawal management is an essential piece of the detox process, which refers to the psychological and medical care a client goes through during drug withdrawal.
With so many substances, medical detox offers the most comfortable and safest setting to manage withdrawal. While a person is in detox, they can safely rid their system of the toxic influence of substances under professional care. The medical professionals will monitor vital signs, such as high blood pressure or elevated body temperature while administering medications that prevent and manage severe symptoms.
The primary objective of detox is to reach a comfortable and safe state of physical and mental stability. A person addicted to opioids, alcohol, benzodiazepines, or other sedatives will benefit from a stint in medical detox to safely manage withdrawal with the lowest likelihood of adverse consequences. Many facilities offer same-day admission detox for those who require immediate medical attention.
How to Prevent Drug Withdrawal From Happening?
Drug withdrawal can be painful, frightening, and even life-threatening, from what we’ve learned. Medical detox will be the best option to stabilize a person going through the process, but what are other ways to prevent withdrawal from happening? One such way is to treat the client with medications. The long-term treatment for substance use disorders may consist of administering different medications to alleviate symptoms and decrease the chance of complications.
Here is an example of medications that might be given during opioid detox:
- Clonidine: A medicine used to decrease the moderate symptoms of opioid withdrawal, including chills, vomiting, sweating, and insomnia.
- Buprenorphine: This is an FDA-approved partial opiate antagonist drug used to treat mild-to-severe opioid use disorder. It controls cravings and reduces withdrawal symptoms
- Methadone: A common and long-lasting full opioid agonist medicine administered to stabilize and maintain a person in recovery from their opioid use disorder. The medication is useful in preventing severe withdrawal from happening.
The following are drugs used to prevent sedative and alcohol withdrawal from happening:
- Benzodiazepines are routinely administered for acute alcohol withdrawal for seizure prophylaxis and other symptomatic management. The individual will then be tapered off throughout the detox stint.
- With certain benzodiazepine dependence, clinicians will administer a long-acting benzodiazepine like chlordiazepoxide or diazepam and be substituted for the benzodiazepine they were abusing. It will then be tapered slowly over a prolonged period to prevent withdrawals.
There is no magical solution to treating drug withdrawal, and each case must be individually tailored to treat withdrawal from drugs that people are dependent upon. If you’re struggling with addiction and ready to get help, make sure to reach out for the help you need today.