There are a variety of barriers in the way of a person ending their struggle with addiction. Limited treatment options, embarrassing social stigma in admitting you need help with a substance use disorder, and simply not being ready to stop using. However, one of the most common barriers to addiction treatment and sobriety, in general, is the fear and discomfort of detox withdrawal symptoms.
Most people who are dependent on an addictive drug have experienced withdrawal symptoms at some point during their lives. Whether it’s by compulsion because of a stay in jail, by necessity because of a surgery or procedure, or simply because you couldn’t get your drug of choice in time, withdrawal can sometimes be difficult to avoid.
Withdrawal can show up with a variety of symptoms including physical pain and discomfort, psychological distress, and powerful drug cravings. Some drugs just cause annoying and troubling symptoms until your body corrects the chemical imbalances in your brain and body, leaving you only with the cravings. Other drugs can produce powerful, life-threatening symptoms that can kill you without medical intervention.
Withdrawal is the monster guarding your escape from addiction and drug dependence. The other side isn’t without its own challenges, but once you get past the monster, you can begin to get to the root of addiction in your life. Through medical detox, you don’t have to go through detox withdrawal symptoms alone. Instead, a team of experienced medical practitioners and clinicians that specialize in addiction treatment can alleviate your withdrawal symptoms as much as possible, maximizing your comfort and helping you to avoid relapse.
Learn about withdrawal symptoms and what you can expect from the chemicals you want to quit.
How Withdrawal Works
Withdrawal rears its ugly head when the flow of chemicals your brain has gotten used to suddenly and jarringly stop. The shaky chemical balance your brain was maintaining while in active addiction is like a house of cards that is suddenly shaking violently by cessation. However, tearing down the house of cards is necessary if it means building a healthy castle of sobriety in its place.
Different Drugs, Different Symptoms
Of course, this is an oversimplification. Different drugs affect the brain in different ways. Stimulants typically increase dopamine production or stop them from being removed through a process called reuptake. The result is a flood of feel-good, mood-lifting chemicals. When your brain becomes used to this and then stimulant use is stopped, you will feel your mood plummet. Opioid receptors, on the other hand, are designed to help manage pain in your body. Opioid dependence can stop your brain from producing its own natural opioids (called endorphins). So, when you suddenly stop using opioids, you will feel a lot more physical symptoms like nausea and body aches.
Cravings and the Limbic System
So, you see how the drug you use can affect the chemistry in your brain and, subsequently, the detox withdrawal symptoms you feel. However, there is one symptom that seems to be common among all addictive, psychoactive drugs: cravings. That’s because cravings have their root in a different part of the brain called the limbic system.
The limbic system is also called the reward center of the brain because its function is to identify and respond to different activities and stimuli you encounter that are rewarding. Certain things in your daily life cause a release of natural feel-good chemicals like serotonin, endorphins, and dopamine. Eating, sleeping, good conversations, and warm hugs are some of the things that release those chemicals. Your limbic system learns that those things are good for you and encourages you to do them again through mild cravings. This response teaches us to repeat things that help us survive and stay healthy.
However, drugs like heroin, cocaine, and alcohol also cause a relapse or excitement of those chemicals in a way that is much more profound than your typical everyday occurrences. Your limbic system is tricked into thinking the drug is extremely beneficial to you and creates powerful cravings.
What are Withdrawal Symptoms
Since different drugs have different effects on your body and brain, and certain withdrawal symptoms can be more dangerous than others, it’s important to know what you are up against with your drug of choice. Here are the most common addictive drugs and the symptoms they can produce during detox withdrawal.
Cocaine
As a stimulant, cocaine causes a number of symptoms but mostly affects mood and psychological responses. Cocaine also has a relatively short half-life and offers a quick high, which contributes to the quick onset of withdrawal symptoms after your last dose. Symptoms can start within a few hours and they can last for up to ten days. Some psychological symptoms may need treatment to be resolved.
Cocaine Withdrawal Symptoms
- Difficulty concentrating
- Fatigue
- Loss of the ability to feel pleasure
- Depression
- Anxiety
- Chills
- Tremors
- Suicidal thoughts or actions
- Sleep disturbances
- Slowed thinking
- Restlessness
Meth
Methamphetamine is another stimulant like cocaine, but with a few key differences. Cocaine blocks the reuptake of dopamine, causing it to linger in the synapse and continue to attach to receptors. Meth does the same thing, but it also increases the initial production of dopamine. The result is so much dopamine flooding the receptors that it actually damages them.
In detox withdrawal, the flood of dopamine stops and there are fewer remaining receptors to even receive a natural dopamine response. During meth withdrawal and after detox, people may experience anhedonia, or the inability to feel pleasure. This can contribute to severe depression and suicide. Suicide rates among meth users are notoriously high. One Australian study reported over 18 percent of the meth-related deaths were suicides.
Meth Withdrawal Symptoms
- Hopelessness
- Loss of ability to feel pleasure
- Muscular weakness
- Deep depression
- Appetite suppression
- Fatigue
- Anxiety
- Apathy
- Insomnia
- Dehydration
- Muscle pain
Heroin
Heroin—and other opioids—affects receptors that control your body’s pain management symptoms. Withdrawal symptoms from opioids after dependence is developed can be extremely unpleasant. Symptoms are often described as flu-like but other symptoms like muscle spasms can also occur.
Heroin & Other Opioid Withdrawal Symptoms
- Nausea
- Vomiting
- Diarrhea
- Stomach pain
- Sweating
- Shaking
- Nervousness
- Anxiety
- Irritability
- Muscle spasms
Alcohol
Alcohol is a commonly abused substance, mostly because of its accessibility and legality. The first sign of alcohol withdrawal can happen within 6 to 12 hours and often appears with shaky hands. Alcohol withdrawal symptoms can be dangerous without medical intervention and if you feel symptoms, you should notify a doctor immediately.
Alcohol Withdrawal Symptoms
- Restlessness
- Anxiety
- Sweating
- Loss of appetite
- Nausea
- Vomiting
- Irritability
- Tachycardia
- Tremors
- Delirium
- Seizures
Benzodiazepines
Benzodiazepines are a central nervous system depressant like alcohol and they are used to treat insomnia, anxiety disorders, and seizures. Like alcohol, benzos can be very dangerous in withdrawal. If you are looking to quit, you should consult a doctor.
Benzodiazepine Withdrawal Symptoms
- Restlessness
- Anxiety
- Sweating
- Chest pain
- Nausea
- Vomiting
- Irritability
- Hypersomnia
- Tachycardia
- Tremors
- Delirium
- Seizures
- Convulsions
When Does Withdrawal Start
The detox withdrawal timeline depends on a number of different factors, not the least of which is the type of drug you are dependent on. In fact, even different drugs in the same category (i.e. opioids, sedatives, stimulants, depressants), can have vastly different withdrawal schedules.
Other Factors
- The drug’s biological half-life. This refers to the length of time it takes your body to process out half of a chemical. At the end of a drug’s half-life, it’s concentration in your blood will drop to half of its original content. The faster your body is able to break down a drug, the more quickly its effects will wear off, and the more quickly your body will begin to miss it.
- The size of the dose you last took. A larger does means that it will last longer in your system.
- The length of time you have used the drug. The longer you use an addictive drug the higher your tolerance and level of dependence will be. If you have a high dependence, you may need more frequent doses to stave off withdrawal symptoms.
- The method by which you take the drug. Whether you inject, snort, or eat a substance can have an effect on the length of time it remains effective in your body.
Generally speaking, opiates like heroin and morphine start withdrawal symptoms between six and 12 hours, meth starts after a few days, cocaine can start within 90 minutes, and alcohol and benzodiazepines start after eight hours.
Which Withdrawal Can Kill You?
While there are many drugs that cause uncomfortable and painful withdrawal symptoms, there are only a few that can actually be deadly. Heroin is the leader in overdose deaths in the U.S. but it’s withdrawal symptoms aren’t typically life-threatening. However, in some cases, sweating, vomiting, and diarrhea can lead to life-threatening withdrawal.
In terms of the most commonly life-threatening withdrawal, central nervous system depressants take the title. Substances like alcohol, benzodiazepines, and barbiturates suppress the nervous system to cause a feeling of relaxation, anti-anxiety, and sedation. After dependence forms, if a person suddenly stops using depressants, the nervous system rebounds in force, causing restlessness, anxiety, and insomnia.
In some cases, Delirium tremens, a condition marked by seizures, convulsions, and catatonia can occur. A significant percentage of cases are deadly when not treated medically.
