Three Common Symptoms of Withdrawal

June 26, 2024

Unravel three common symptoms of withdrawal from alcohol, opioids, and benzodiazepines, and how to manage them.

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Understanding Withdrawal Symptoms

Withdrawal symptoms are a collection of changes in behavior, mood, and physiology that occur when a person stops or reduces the intake of a substance they are dependent on. These symptoms can vary in severity and duration depending on the substance and the individual's level of dependence.

Overview of Withdrawal Symptoms

Three common symptoms of withdrawal include aches and pains, extreme fatigue and lethargy, depression and anxiety [1]. Another representation includes cravings, anxiety, and fatigue.

The symptoms experienced can differ depending on the substance in question. For example, symptoms of alcohol withdrawal can range from mild to severe and can start as early as 6 hours after stopping drinking, depending on the duration and amount of alcohol consumption. On the other hand, symptoms of opioid withdrawal can include physical discomfort, such as nausea, vomiting, diarrhea, as well as psychological distress, like anxiety, and insomnia [4].

Substance Common Withdrawal Symptoms
Alcohol Aches and pains, fatigue, depression, anxiety, hallucinations
Opioids Nausea, vomiting, diarrhea, anxiety, insomnia
Benzodiazepines Anxiety, sleeping disorders
Stimulants Anxiety, unstable emotions, erratic sleep patterns, strong drug cravings

Importance of Managing Withdrawal

The management of withdrawal symptoms, also referred to as Withdrawal Management (WM), is crucial for the health and safety of the individual. WM refers to the medical and psychological care of patients who are experiencing withdrawal symptoms as a result of ceasing or reducing use of their drug of dependence.

Without proper management, withdrawal symptoms can be severe and potentially life-threatening. Managing these symptoms can reduce discomfort, prevent serious complications, and increase the likelihood of successful recovery. It's important to seek professional help when attempting to stop the use of a substance, as healthcare professionals can provide the necessary support and resources to safely navigate through the withdrawal process.

Common Symptoms of Alcohol Withdrawal

Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol every day suddenly stops drinking alcohol. These symptoms can start as early as 6 hours after stopping drinking, ranging from mild to serious, depending on the duration and amount of alcohol consumption. This section covers the early onset symptoms and the more serious symptoms and complications of alcohol withdrawal.

Early Onset Symptoms

Early onset symptoms of alcohol withdrawal typically include cravings, anxiety, and fatigue. Other symptoms may include aches and pains, extreme fatigue and lethargy, and depression and anxiety. More specifically, the following symptoms can be observed:

  • Anxiety
  • Nervousness
  • Trembling
  • Rapid heart rate
  • Sweating
  • Irritability
  • Fatigue
  • Depression
  • Mood swings
  • Nightmares
  • Not thinking clearly

The intensity of these symptoms can range from mild to severe, depending on factors such as the amount of alcohol consumed and the duration of alcohol consumption.

Serious Symptoms and Complications

In some cases, alcohol withdrawal can lead to more serious symptoms and complications. These may include hallucinations, which can start about 12 to 48 hours after the last drink, with possibilities of seeing, feeling, or hearing things that aren't there and seizures within the first 2 days after stopping.

Severe symptoms like delirium tremens (DTs), which occur in about 5% of people with alcohol withdrawal, can include vivid hallucinations and delusions, usually starting around 48 to 72 hours after stopping drinking.

These serious symptoms and complications often require immediate medical attention. It's important to seek help if you or someone you know is experiencing these symptoms during alcohol withdrawal.

The severity and duration of alcohol withdrawal symptoms can vary widely among individuals. Factors such as the length and quantity of alcohol use, as well as individual health status, can significantly affect the withdrawal response. Recognizing and understanding these symptoms is a crucial step in managing alcohol withdrawal and promoting recovery.

Symptoms of Opioid Withdrawal

Understanding the symptoms of opioid withdrawal is crucial for effectively managing the condition and ensuring a safe and successful recovery process. Withdrawal symptoms can be broken down into two primary categories: physical symptoms and psychological symptoms.

Physical Symptoms

During the withdrawal process from opioids, individuals typically experience a range of physical symptoms. These symptoms often resemble a severe flu-like illness and include yawning, sneezing, runny nose, nausea, diarrhea, vomiting, and dilated pupils.

The onset of these symptoms can start as soon as 6 to 12 hours after the last dose of the opioid was taken and can last for a week or more. The duration and severity of these symptoms depend on the type and dose of the opioid used and the duration of its use [6].

It's worth noting that physical symptoms of opioid withdrawal can occur after one month of taking an opioid every day.

Physical Symptoms
Yawning
Sneezing
Runny nose
Nausea
Diarrhea
Vomiting
Dilated pupils

Psychological Symptoms

In addition to physical symptoms, individuals undergoing opioid withdrawal may also experience a number of psychological symptoms. The most common of these symptoms include anxiety and insomnia.

Although these symptoms can be distressing, it’s important to remember that they are a normal part of the withdrawal process and will eventually subside as the body adjusts to the absence of the drug. Seeking support from healthcare professionals or support groups during this time can be extremely beneficial in managing these psychological symptoms.

Psychological Symptoms
Anxiety
Insomnia

The complex nature of opioid withdrawal underscores the importance of seeking professional help when deciding to stop or reduce opioid use. By understanding the potential symptoms and challenges associated with withdrawal, individuals can better prepare for the process and increase their chances of a successful recovery.

Managing Benzodiazepine Withdrawal

Dealing with benzodiazepine withdrawal involves understanding the phases it encompasses, and the factors that influence the severity and duration of symptoms. It's crucial to navigate this process with proper knowledge and medical guidance to ensure a safe withdrawal journey.

Phases of Benzodiazepine Withdrawal

Benzodiazepine withdrawal generally unfolds in three main phases: early withdrawal, acute withdrawal, and protracted withdrawal.

Early Withdrawal: This phase may commence within a few hours to a few days of discontinuing the medication and may last a few days. Symptoms during this stage can include anxiety, trouble sleeping and muscle pain [7].

Acute Withdrawal: Constituting the majority of withdrawal, this phase can include symptoms like intensified anxiety, panic, insomnia, muscle spasms, nausea, and vomiting.

Protracted Withdrawal: This phase can extend several months or even years after stopping the use of benzodiazepines, with symptoms such as tingling in the extremities, muscle twitches, prolonged anxiety, insomnia, cognitive deficits, depression, and mood swings [8].

Factors Affecting Benzodiazepine Withdrawal

The onset and severity of benzodiazepine withdrawal symptoms can be influenced by various factors. These factors include the specific type of benzodiazepine used, the duration of use, the dosage, and the method of discontinuation.

Withdrawal symptoms can begin several hours after stopping a short-acting benzodiazepine or up to three weeks after stopping a long-acting benzodiazepine.

Moreover, sudden discontinuation of benzodiazepines can lead to more severe withdrawal symptoms, including seizures and hallucinations. Therefore, it is always recommended to gradually taper the dosage under the supervision of a healthcare professional.

Understanding these factors can help individuals better anticipate the withdrawal process and equip them with the necessary knowledge to manage these symptoms effectively. However, it's crucial to remember that each individual's experience with withdrawal can be unique, and professional medical guidance is essential during this process.

Withdrawal Response to Drug Cessation

Understanding the body's withdrawal response to the cessation of different substances is crucial in managing and treating withdrawal symptoms effectively. The response can significantly vary depending on the substance involved, the duration of use, and the individual's overall health status.

Alcohol Withdrawal Response

Withdrawal symptoms from alcohol can occur within 6 to 24 hours after cessation of alcohol consumption, particularly in individuals who have been consuming alcohol for at least 1 to 3 months or have consumed large quantities for at least seven to ten days. These symptoms can be immediately relieved by consuming additional alcohol, which can lead to a dangerous cycle of dependency.

It's important to note that severe withdrawal symptoms, such as Delirium Tremens (DTs), can be life-threatening and require immediate medical attention. Patients with DTs or other severe symptoms may require admission to the intensive care unit due to the risk of mortality.

Opiate and Sedative Withdrawal

The use of sedatives like barbiturates and benzodiazepines can also produce withdrawal responses that resemble alcohol withdrawal syndrome. These symptoms, characterized by autonomic and psychomotor dysfunction, tend to develop 2 to 10 days after discontinuation of the agent [5].

The withdrawal symptoms of benzodiazepines may include anxiety, trouble sleeping, and muscle pain. In some cases, individuals may experience more severe withdrawal symptoms if they suddenly stop taking benzodiazepines, including seizures and hallucinations [7].

These withdrawal symptoms can be extremely uncomfortable and, in severe cases, life-threatening. Therefore, medical supervision is usually recommended when individuals are undergoing withdrawal from these substances.

It's important to understand that the severity and timeline of withdrawal symptoms can vary greatly from person to person. Therefore, it's crucial to seek professional help when deciding to stop the use of these substances. Medical professionals can provide the necessary support and guidance to help individuals navigate through the withdrawal process safely and effectively.

Impact of Stimulant Withdrawal

Stimulant withdrawal is a natural process that takes place when an individual who has been using stimulants such as amphetamines or cocaine decides to stop or significantly reduce their use. The body, having adapted to the presence of these substances, reacts when they are no longer provided, leading to several withdrawal symptoms.

Symptoms of Stimulant Withdrawal

Symptoms of stimulant withdrawal can vary from person to person, depending largely on the type of stimulant used, the duration of use, and the individual's overall health. Common symptoms include anxiety, unstable emotions, erratic sleep patterns, and strong cravings for the stimulant drugs.

People withdrawing from central nervous system (CNS) stimulants like cocaine and amphetamine may also experience marked depression, excessive sleep, hunger, dysphoria, and severe psychomotor retardation. However, it is important to note that unlike withdrawal from certain other substances, such as alcohol or benzodiazepines, stimulant withdrawal is generally not life-threatening.

Stimulant Common Withdrawal Symptoms
Amphetamines Anxiety, unstable emotions, erratic sleep patterns, strong cravings
Cocaine Marked depression, excessive sleep, hunger, dysphoria, severe psychomotor retardation

Recovery Process and Duration

The recovery process from stimulant withdrawal is often gradual, requiring the individual to navigate through various stages of physical and psychological discomfort. The duration of the recovery process will depend on several factors, including the individual's overall health, the duration and intensity of stimulant use, and the support available to the individual during this time.

The acute phase of stimulant withdrawal can last anywhere from a few days to a week, during which physical symptoms are most intense. This is followed by a protracted phase, which can last for several weeks, during which psychological symptoms such as depression and cravings may persist.

Support from healthcare professionals, alongside a strong support network, can significantly help an individual navigate the challenges of stimulant withdrawal. Ensuring proper nutrition, regular exercise, and adequate sleep can also aid in the recovery process. If you or someone you know is considering withdrawal from stimulants, it is highly recommended to seek professional help to ensure a safe and effective recovery process.

References

[1]: https://www.samhsa.gov/find-help/national-helpline

[2]: https://www.canada.ca/en/health-canada/services/substance-use/get-help-with-substance-use.html

[3]: https://www.webmd.com/mental-health/addiction/alcohol-withdrawal-symptoms-treatments

[4]: https://www.ncbi.nlm.nih.gov/books/NBK310652/

[5]: https://www.ncbi.nlm.nih.gov/books/NBK459239/

[6]: https://www.healthdirect.gov.au/opioid-withdrawal-symptoms

[7]: https://www.mind.org.uk/information-support/drugs-and-treatments/sleeping-pills-and-minor-tranquillisers/withdrawal-effects-of-benzodiazepines/

[8]: https://americanaddictioncenters.org/benzodiazepine/length-of-withdrawal

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