When a person abruptly stops using a substance such as alcohol, prescription drugs, or recreational drugs, withdrawal arises. During withdrawal, physical and mental side effects are experienced.
How long withdrawal lasts and when symptoms begin can vary. Factors that affect this include the substance used, duration of usage, and a person’s general health and well-being.
In most cases, though, people begin feeling initial withdrawal symptoms two to three days after using drugs or alcohol.
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Withdrawal symptoms are a normal part of detox, which is the first stage of recovery for a substance use disorder or drug addiction. During detox, harmful toxins leave the body, enabling many people to begin to overcome the effects of drug abuse physically. However, the length of time it takes to detox varies depending on the drug a person is detoxing from.
Detox can be completed at home via an outpatient facility or by attending an inpatient treatment facility. Depending on the facility and the severity of the addiction, those in recovery can either complete a natural detox or medical detox.
Medical detoxes are carried out via inpatient treatment facilities. Here, medical professionals provide medical supervision and prescribe medication to help alleviate withdrawal symptoms and ease the detox process.
Depending on the severity of drug abuse, detox may see a person gradually taper off of using certain drugs. Tapering use means progressively using a lower quantity or strength of a substance until use stops completely.
When a medical detox is sought, withdrawal symptoms are generally less severe. However, the symptoms experienced depend on the substance.
Alcohol withdrawal symptoms vary depending on how severe addiction is. However, they typically include:
- Rapid heart rate
Light to moderate drinkers often experience mild symptoms that alleviate somewhat quickly. In contrast, severe alcohol withdrawal often requires medical attention, especially as fevers, seizures, tremors, hallucinations, and convulsions can be life-threatening.
Even those who abuse a small amount of alcohol are at risk of experiencing withdrawal symptoms, so medical detoxes are usually recommended to anyone hoping to reduce their alcohol intake.
In America, three million people are thought to have an opioid use disorder. Those living with this condition usually abuse opioid drugs such as oxycodone, hydrocodone, heroin, and fentanyl.
As opioids are highly addictive substances, people often build up a tolerance quite quickly. This means that they need to take a higher dose to feel the drug’s effect. Sadly, taking an increasing amount of opioids to feel the same effects often leads to opioid dependence, causing many people to rely on the drugs.
Though sometimes overlooked, opioid dependency can arise when prescription drugs, such as those prescribed by medical professionals, are abused. An addiction can also occur when illicitly bought drugs are taken.
Unfortunately, when drugs like heroin and fentanyl are taken, there is a high overdose rate. In fact, over 70% of drug overdose deaths in America in 2019 involved an opioid.
When withdrawing from opioids, relapse can be common as withdrawal symptoms are unpleasant, although not generally fatal.
Opioid Withdrawal Timelines
The withdrawal timeline is heavily affected by the type of opioid a person is detoxing from. For example, short-acting opioids, such as heroin, can cause withdrawal symptoms to begin just a few hours after the last dose. However, this depends on how long a person has been taking the opioid and the amount normally consumed. With short-acting opioids, withdrawal symptoms generally peak between 36 and 72 hours and continue for up to 10 days.
In contrast, longer-acting opioids, such as fentanyl and methadone, aren’t cleared from the body as quickly, so the withdrawal process can last longer. Drug withdrawal symptoms for substances like methadone can begin as late as two to three days after the last dose.
The withdrawal peak, where people generally experience the most severe symptoms, usually surfaces around day three. This stage is often called the protracted withdrawal period. In total, the symptoms of withdrawal can linger for about 23 days.
Common Opioid Withdrawal Symptoms
There are different stages of withdrawal. In the early stages of withdrawal – the acute withdrawal period – people generally experience symptoms such as:
- Flu-like symptoms
- Watery eyes
- Excessive sweating
- Runny nose
During the protracted withdrawal period, symptoms include:
- Loss of appetite
- Trouble sleeping
- Feeling weak
- Increased blood pressure
- Agitation and restlessness
- Bone and muscle pain
Post-Acute Withdrawal Syndrome (PAWS)
PAWS usually arise six months after a person stops using a substance and can last for up to two years. While the majority of recreational drugs and alcohol can cause PAWS symptoms, there are some drugs that are more likely to cause PAWS.
- Marijuana. Insomnia, which is a withdrawal symptom of marijuana detox, can lead to PAWS if untreated.
- Cocaine. Decreased impulse control and depression can be experienced for months after cocaine detox.
- Methamphetamine. Often impulse control functions are inhibited, sometimes for years after withdrawing from methamphetamine.
- Opiates. Insomnia, anxiety, depression, and decreased impulse control may be encountered if opiate PAWS are experienced.
- Benzodiazepines. Benzodiazepine withdrawal, in particular, can result in PAWS. Though many people are prescribed benzos for conditions including depression or anxiety, symptoms of anxiety can return after quitting benzos alongside PAWS, worsening the initial issues. Here, panic attacks, extreme anxiety, and insomnia are not uncommon. Benzodiazepine dependence is incredibly challenging to deal with alone. But adverse consequences, such as severe depression and relapse, can be avoided by seeking professional medical help.
Dealing With Unpleasant Symptoms
Withdrawal effects can significantly vary. While some people experience physical symptoms such as losing their appetite and high blood pressure, others may experience psychological symptoms such as anxiety or hallucinations.
In some instances, more severe symptoms can cause a person to relapse. Experiencing withdrawal symptoms such as delirium tremens (DTs), for example, can be incredibly stressful and even dangerous. However, facilities and treatment plans are available to help treat withdrawal symptoms and support each person through the detoxification process.
As part of a medical detox inpatient program, treatment is also available for mental health issues and substance use disorders, as are medications that can ease symptoms.
While the thought of attending a detox may seem scary, the risk of relapse significantly decreases when medical detox is completed due to managing withdrawal symptoms. It’s not just physical symptoms that professional detox can help with. Having a strong support network is crucial for long-term recovery, and entering treatment is the perfect chance to make connections that facilitate lifelong change.
Detox itself is rarely enough to result in long-lasting sobriety. Some people choose to complete an inpatient treatment after their medical detox, where they stay at a treatment facility. Others may prefer to opt for treatments such as therapy that do not have a heavy impact on their daily schedule, and so they choose an outpatient option.
Alcohol and substance abuse treatment can be daunting, but treatment centers offer holistic and flexible options. Sober life requires hard work and emotional support, so seeking treatment or joining a support group is always a positive step.