Drug Withdrawal Symptoms, Timelines, and Treatment

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Drug withdrawal symptoms, timelines, and treatment for those who are dealing with substance abuse often reach what some call a "rock bottom" before they decide it’s time to begin their recovery process. One of the most common barriers to addiction treatment and quitting drugs in general is the withdrawal process. Withdrawal is not an easy or straightforward process.

This is because not only will a person experience physical withdrawal symptoms but physical symptoms as well. Many people expect the physical side effects but are not equipped for the severity of all of the alcohol, benzo or opiate withdrawal symptoms. There are many different stages of withdraw and it differs for various drugs, too.

In this guide, we’re going to explore withdrawal and all it means for those who are going to experience it.

What Is Withdrawal?

Withdrawal occurs when a person discontinues use of a certain substance. After periods of regular drug and alcohol use, a persons body becomes dependent. Different substance help emit different chemicals in the brain.

For instance opiates significantly increase the level of dopamine released in the human brain. When a person begins an opioid detox their brain needs to start to create its own dopamine again without the assistance of opiates.

When a person begins an opioid detox their brain needs to start to create its own dopamine again without the assistance of opiates. This causes people to experience mental health issues like depression and anxiety. An opiate withdrawal timeline can be found later in this article.

There are different physical, mental, and emotional withdrawal symptoms a person will have to overcome depending on their drug of choice. Some mental and emotional symptoms a person can expect include:

  • Anxiety
  • Depression
  • Insomnia
  • Cognitive issues such as poor memory and concentration

The physical withdrawal symptoms include:

  • Headaches and dizziness
  • Chest tightness
  • Palpitations and racing heart
  • Nausea and vomiting
  • Diarrhea and stomach pain
  • Muscle tremors, shakes
  • Sweating and tingling
  • Gastrointestinal issues

The Science of Addiction & Withdrawal

Whenever you think about a person experiencing substance abuse abuse, you might think of someone who is abusing alcohol or drugs. However, it’s essential to know that they can also be addicted to certain behaviors.

For example, it may seem confusing to be addicted to sex, gambling, shopping, or smoking, but behavioral addiction is just as chemical as substance addiction. The chemicals that are naturally occurring in the brain during an addiction have withdrawal symptoms that are psychological and occur for both substance use and behavioral addictions.

How Addiction Works

Drugs and alcohol - as well as behavior addictions - work on the natural processes inside the brain. When this happens, large quantities of dopamine and endorphins are released, and they are intended for the body to use in ordinary circumstances.

Dopamine is the "reward chemical," which makes us feel good and reinforces the behaviors that allow for dopamine production.

Other activities like shopping can stimulate the same chemical release, which is why behavioral and drug addictions feel the same psychologically.

People become addicted to these dopamine rushes, and often continue to do whatever it is that triggers this rush.

When the action which produces these euphoric effects suddenly stop, the brain becomes overwhelmed. Withdrawal symptoms will begin like anxiety and restlessness and those who take drugs will immediately notice the difference.

Different people deal with various manifestations of withdrawal, and the symptoms are ultimately linked directly to the chemical imbalance in the brain. It takes some time, but the brain DOES readjust itself - it’s just sticking with an individuals treatment program that’s most important.

Withdrawal As The Epicenter Of The Recovery Process

Without going through those initial withdrawals, a person cannot make it to recovery. The detox process is the first step to achieving a healthy lifestyle. It’s not that they should be in any pain from their alcohol/drug addiction, but they have to get through the withdrawal symptoms to detox their body from the drug. It’s a very vital part of the process, and those who have to go through it do so to get to the other side.

Phases of Withdrawal

Substance abuse can be tough to overcome but it is possible. There are two phases of drug/alcohol withdrawal that you should know about. Let’s explore them both to get a clearer picture of the phases of withdrawal.

Acute

The acute withdrawal phase is the initial withdrawal a person will experience. This is where the substance starts to leave the body and those substance timelines vary depending on many different variables. The initial withdrawals are the most severe and the physical symptoms are most prominent.

In acute withdrawal a person may experience the side effects mentioned earlier like vomiting, shaking, diarrhea, sweating etc. These initial withdrawal effects can last anywhere from a few days to months. Experiences vary dependent on the substance a person is using, their personal physical health, age, length of use and how much they use.

Post-Acute

Post-acute withdrawal syndrome also known as "PAWS" can last anywhere from a few weeks to two years. This period is defined by less severe symptoms which gradually get better in time.

It’s very important to keep this in mind that when a person experiences withdrawal symptoms, it can last that long. This information is not to scare anyone but to educate them so that they are aware that even though most physical symptoms have passed, there are still long term side effects of drug use.

Many people will go through initial withdrawal and start to feel much better physically only to experience mild to severe depression or anxiety. When these mental health issues arise, some people may believe its because they don't like their new healthy lifestyle or something else but it is likely just post acute withdrawals which will get better over time.

Mood swings can occur during this period, especially as the substance is removed. The brain has to take time to rebalance itself, and this can involve depression and fatigue along with other withdrawal symptoms, including individual experiences of decreased pleasure in normal pleasurable activities.

This happens because the areas of the brain which produce the feel good chemicals like dopamine and others are healing themselves and the chemicals are no longer being manipulated with drugs and alcohol. Quitting drugs and alcohol is very similar to grieving - when in the midst of the withdrawal process, they no longer take the substance that induced the euphoria in the first place.

That depression and fatigue can persist over time, and this may lead to the individual seeking further help for the depression. The drug/alcohol addiction could have masked this depression for quite some time, and so it would now need some concentrated help from a professional.

Another side effect that individuals could experience include panic attacks and anxiety. While taking a substance, an individual is "in control" of their own life - so they think. So, when that substance that makes them feel in control is gone, the underlying anxiety and panic rears its ugly head.

Cognitive-behavioral therapy and other therapies can help here. Post-acute withdrawal syndrome has no specific cause, and the timelines are not defined here. When people are going through withdrawal, they can prepare themselves for post-acute withdrawal syndrome as well as the timelines for the process of withdrawal itself.

The important thing to remember is to focus on the positive changes during this process, even if it feels particularly hard. It’s very easy to focus on negative things when going through withdrawal - especially if a person is suffering from post-acute withdrawal syndrome. It’s vital to remember that recovery changes the person’s life for the better while also healing the brain. By practicing the right self-care, individuals will eventually get to a full recovery place in life. Staying active can also help with recovery, helping the brain heal faster.

Withdrawal Timelines

There are a variety of timelines for each drug/alcohol withdrawal, and once a person understands the process, it makes dealing with the withdrawal easier. It’s always better to know that there is a light at the end of the tunnel, even if it’s a difficult road to stay focused on. Let’s take a look at the timelines for a variety of drugs.

Opiates

Opiate withdrawal symptoms vary depending on your age, how much you used various opiates and your general health. On average, the symptoms themselves set in between 6 and 24 hours after the final dose, and opiate withdrawal symptoms continue for a week. In the opiate withdrawal timeline the initial pain and discomfort peaks around day three. After day three many opioid withdrawal symptoms will start to improve. However, depression and anxiety can be left behind for months, and in some rare cases, years.

Once the persons initial high fades, about ten hours after their last use a person will deal with initial opiate withdrawal symptoms like depression and anxiety. It’s then that the initial cold chills and lethargy associated with opiate withdrawal set in. The acute period of opioid withdrawal symptoms begins on day two in most cases, with intense anxiety, severe bowel movements, and muscle pain.

The opioid withdrawal symptoms on the second day often include muscle pain can be accompanied by profuse sweating and insomnia, and heightened blood pressure. Most people will also experience a loss of appetite during their opioid withdrawal. By day six of the opiate withdrawal timeline most of the acute symptoms are gone, and the leftover symptoms of depression and anxiety, as well as a loss of appetite, may continue to linger but decrease.

The exact timeline varies from person to person, but this is a estimated opiate withdrawal timeline.

Cocaine

There are various stages to cocaine withdrawal and understanding each one helps the person to know what to expect during them. It’s very typical to be overwhelmed by the symptoms of withdrawal from cocaine, especially when you learn that symptoms of withdrawal don’t end overnight; they can last for months and even years if PAWS (post-acute withdrawal syndrome) occurs. Knowing what’s coming assists in the management of symptoms and can reassure you that they need to continue the recovery journey they are on.

In the first 24-72 hours of withdrawal from cocaine, there is a crash. The brain will become very sleep-deprived, and the body goes through some extreme fatigue. The problem is that it’s tough to rest, especially when the person is used to feeling high and euphoric instead of depressed and anxious. They sleep, but they don’t feel particularly relaxed. By the end of week one, though, some improvement has occurred, with cravings feeling more manageable.

By the second week, there is a jump, where the person can feel like they are moving backward in their recovery. The cravings might return, and as those cravings are accompanied by agitation, the vivid dreams can make a vulnerable person consider buying more of it.

Symptoms of withdrawal still occur through week three and four, too, which is when mood swings are present, and depression is also very common. Exercise, eating well, and distraction can help with these two weeks.

From week five onward, the intense cravings can continue, even in the moments which they least expect it to happen. The brain is healing, and therapy and medication for the depression can help.

Alcohol

There are three recognized levels of alcohol withdrawal, and there are different symptoms within each of these levels. The symptoms of withdrawal begin to set in within six hours of the last drink, with the most severe symptoms of alcohol withdrawal occurring as late as ten days after the last drink. The recovery process for an alcoholic is a complicated one and can take some time to get on track.

Marijuana

With marijuana, despite it being seen in the world as a natural drug (given where it comes from), it still has a withdrawal process that users must deal with going through. The process happens as follows:

The first three days are where the withdrawal symptoms begin, and they usually start with anxiety, depression, mood swings, and - in some cases - sweating and the shakes. These are the initial symptoms after the last hit.

In the first week, most people experience intense withdrawal symptoms, and by day ten, the physical symptoms begin to slow down, and mood begins to stabilize. Cravings can, however, continue.

By the end of week two, any remaining physical symptoms are usually gone, from the muscle aches and insomnia to the appetite problems. Cravings can still continue beyond week two, though, so it’s important to feel prepared for that.

In week three, marijuana metabolites are usually gone, and the withdrawal symptoms are also almost all out of their system. Any symptoms rarely go beyond the first month, but it very much depends on the user and how much they relied on marijuana in the first place.

Benzodiazepines

Within the first couple of days of stopping benzos, the early symptoms will appear of withdrawal. These usually are reasonably mild, with difficulty sleeping and mood swings being apparent. Nausea and headaches follow, and other symptoms typical of withdrawal start to take place, too.

By the end of the second week, the phrase "It gets worse before it gets better" will become very obvious. The benzo withdrawal symptoms will peak by now, and the mild symptoms will feel more and more intense. It’s at this point most people start to wonder if they should go back for another hit. It’s also when they begin to lose some muscle control.

Seizures are prevalent at this point, and this can go on for some time if the individual has multiple addictions - as is familiar with those who take benzos. Body tremors and hallucinations are extreme symptoms here, and these often appear when the patients choose to go cold turkey with their treatment. After one month, though, the signs are beginning to fade. This is when the psychological effects come into full force and can last for some time.

After a month, the worst is usually over, but people should not be discouraged if they have a surge of symptoms all over again. This is common, and the setbacks can be intense, but all is not lost when it happens. It’s extremely common to experience fluctuations in symptoms as they fade.

Several months down the line, patients who are dealing with higher dosages of benzos can still experience symptoms. These can go on for years, which may sound disheartening, but it does depend on the patient and how long they have abused benzos previously. Those who have a dual-diagnosis with another drug have the hardest time in recovery.

Methamphetamines

Within one to two days of finishing the last methamphetamine, the crash happens. Meth takes up a lot of the resources in the body, and during those first two days, the comedown is horrendous to deal with. The body has no energy and is open to disease.

Individuals who come off of meth deal with fatigue, increased appetite, and excessive sleep in the first couple of days. By day ten, the emotional side effects happen, from paranoia and unease to even more fatigue. Suicidal thoughts are not uncommon, but by day ten, they decline. Meth users often feel depressed in their withdrawal, and this can continue up until week four.

By the end of week three, subacute withdrawal is evident, and problems related to sleep and appetite will continue. Heart rates can often slow, and this can linger for several weeks, which is why most of those in meth withdrawal need someone closeby - bradycardia is not a joke and can be dangerous.

It’s not easy to identify precisely when meth withdrawal ends because it’s unique to the individual. Those who have abused meth for years experience stronger effects compared to someone that has been on the drug for a couple of months.

Overcoming meth addiction is harder than most, as the withdrawal phase is so demanding on the body. Those who are going through it often fall and take meth because the symptoms are just too hard to cope with over the first three weeks. It’s these individuals that aren’t quite ready to go through the detox and withdrawal process, but this doesn’t make them failures. Trying to go through withdrawal over and over again is a strength.

The Role of Detox In Withdrawal

The very first step towards sobriety is detox is detox. It’s a tough process, and it takes a lot of strength to go through it, but it’s not easy. People who go through detoxing show an incredible level of strength, and there are different ways to get through it.

There are many different types of detox available for people to try, and medication managed detox is a common one to go through. A doctor can help you to relieve the symptoms of withdrawal and move through it under close supervision. Many people fear the pain of withdrawal, which is what stops people from continuing, and this then leads to relapse.

They can hear stories from others regarding the lack of care from their physicians when it comes to their recovery, and it puts them off. However, with the right treatment and the right facility and doctor, withdrawal and recovery are both possible to get through.

No two patients experience withdrawal in the same way, and this depends on the substance that is being abused. It also depends on how severe the abuse is and how long it’s been going on. There are many different symptoms of withdrawal to be aware of, and these range from the physical to the psychological. Some of the symptoms include:

  • Nausea/vomiting
  • Sweating
  • Constipation/diarrhea
  • Difficulty breathing
  • Body/muscle/bone aches
  • Rapid heart rate
  • Cravings
  • Anxiety/irritability
  • Insomnia
  • Depression
  • Restlessness
  • Confusion

Those moving through detox must stay as hydrated as possible through it. Some of the detox options out there include IV therapy, where patients can receive the medication as well as hydration fluids through an IV. It’s an excellent method to use, though, because they can have their medications adjusted as they need, and there’s no need to wait for the oral medication to start to work.

Detox programs vary in their length, depending on whether they are medication managed or entirely about being in a rehabilitation facility. Once detox is completed, and the drugs and alcohol have both left your system, it’s usually recommended that the person goes through a rehab program as either an inpatient or an outpatient.

When you call Addiction Helpline America, you get a service that can direct you to the best facilities and doctors to handle the recovery for your specific drug/alcohol addiction. Don’t be afraid to ask for help - we are here to do just that, and you must get the right advice before it’s too late.

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