The Centers for Disease Control, or the CDC, reports that in the year 2017, over 11% of all Americans 12 years and above had used an illicit substance within the month, before being surveyed. Of this figure, the majority used a substance that was associated with tolerance and physiological dependence. When it comes to substances that are associated with dependency and addiction, the user may experience uncomfortable and sometimes painful symptoms of withdrawal.
How long the withdrawal symptoms persist as well as their severity depends on multiple factors. For instance, the drug of choice will have a lot of say. The duration of drug use is yet another factor that comes into play. Regardless, withdrawal symptoms, for as long as they are present, will be uncomfortable. However, in most cases, the former user will have an easier time after the first 7-10 days. It often is a case of riding a 7-10-day storm.
Attempting detox for varied substances will raise varied withdrawal symptoms. Withdrawal effects will vary from drug to drug. Most drugs and substances will have uncomfortable withdrawal symptoms, which are rarely life-threatening. Others will have more severe ones, which can be fatal if the detox process is not done under the care a qualified medical professional.
It is advisable to only attempt detox in a facility where professional care is present. Some people have indeed toughed it out and completed detox on their own. However, this is a very slim minority, and in the case where harder drugs like meth were involved, it is not unthinkable that at points in their detox process, their lives were genuinely in danger.
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When you use a drug or even alcohol for an extended period, your body adjusts to the substance being in its system. It begins to become dependent on the presence of the drug or substance for normal functioning.
Many drug addicts will use and abuse drugs just to feel normal. It is also common for an alcoholic to take alcohol just so he or she can be himself.
When you try cold turkey quitting, the result is immense discomfort as your body tries to adjust to the absence of the drug. Remember that the body has already become accustomed to functioning with the drug in the system. Withdrawal symptoms will set in if you stop using, or drastically cut the amounts of the drug you take.
Drug withdrawal has been explained as your body trying to arrive at a new level of homeostasis. It does so as it dispels remnants of the drug in your system. The result is significant chemical shifts in the body. These bring about mental and physical repercussions.
Drug dependence will be reliant on the dose of the drug that is taken. It is also true that dependence, and the withdrawal effects that arise from quitting a drug or cutting down on the amounts taken vary from drug to drug. For example, withdrawal effects of an antidepressant drug will not be the same as those of a prescription opioid like OxyContin.
Opiate withdrawal symptoms include shaking, sweating, nausea, and vomiting. The withdrawal symptoms of alcohol include nausea, sweating, irritability, and fatigue. Nicotine withdrawal may cause irritability, headaches, insomnia, and fatigue. You may also have difficulty focusing.
The administration route will also have a say on the severity and duration of withdrawal symptoms. For instance, people who inject drugs directly into their bloodstream will have harsher withdrawal symptoms compared to those who smoke or snort their drugs.
There are different withdrawal symptom stages, as well. Typically, you will crash/come down, then you will feel worse progressively before hitting a plateau and then slowly but steadily feeling better.
Most drugs do not have life-threatening withdrawal symptoms. However, some do, with the examples of alcohol, barbiturates, benzos, and glucocorticoids. Opiate withdrawal symptoms are rarely fatal. However, they do lead to miscarriages due to fetal withdrawal.
The term "cold turkey" points to the sudden prompt cessation of drug intake. This leads to psychological manifestations, as the body adjusts to the absence of drugs. Withdrawal often comes as a package of mental, physical, and emotional symptoms.
Drug withdrawal duration will be dependent on the drug of choice. Usually, it will take mere days - 7-10 days at most. In some cases, however, it may drag on for weeks, perhaps even months. If you have gone through withdrawal symptoms and relapsed before, withdrawal effects may hang around for longer than usual.
Here is a general overview of certain drugs and their withdrawal timeline:
i) Short-Acting Opioids (with the examples of heroin and some prescription painkillers): Symptoms will typically start 8-24 hours after the last fix. They will last anywhere from 4-10 days.
ii) Longer-acting opioids (with the example of methadone): Longer-acting opioids usually have their withdrawal symptoms emerge 2-4 days after the last dose. The signs will fade after ten days or so.
iii) Benzodiazepines (with the examples of Valium, Xanax, Clonazepam, Klonopin, and Ativan): Benzo withdrawal will start after 1-4 days. The severity of withdrawal symptoms will peak in the initial two weeks after quitting the drug. With benzos, it is true that withdrawal can drag on for months - even years - if treatment is not administered correctly.
iv) Cocaine: Cocaine exits the system quickly. As such, withdrawal symptoms will set in soon, typically only a few hours after the last fix. They will peak within a few days of quitting the drug but will start to dissipate after a week. If you are a heavy user, some symptoms may persist for up to 10 weeks.
v) Alcohol: The first alcohol withdrawal signs will appear a few hours after the last drink. They will peak within 24-48 hours. Alcohol withdrawal symptoms can be fatal. You also risk developing seizures, and, in more severe cases, delirium tremens 12-48 hours after.
Heroin is an opioid, which is to mean it is in the opioid drug family. Opioids function by attaching to opioid receptors in the body and activating them. When opioid receptors are activated, dopamine is produced in the brain. Dopamine is the pleasure chemical - it is typically produced when you engage in an activity that rewards you or causes pleasure.
Opioids are widely abused, especially in the US. They have long been considered highly addictive. Even when following a strict, medical prescription, dependence, tolerance, and addiction may still set in. This is evident with how the number of people struggling with a painkiller addiction in the US.
Acute opioid withdrawal syndrome includes symptoms such as:
Withdrawing from heroin and other opioids is hardly ever fatal. However, the flu-like symptoms of withdrawal are uncomfortable - sometimes immensely so - and they can provide challenges to recovery. It is essential that withdrawal only happens in a medically professional setting. Doctors can monitor your vitals, use medications to stave off symptoms and cravings, and keep you from relapsing.
Benzos are used to treat panic disorders, seizure disorders, and, most often, anxiety. People have described being on benzos like Xanax as "having nary a care in the world." They have described feeling immensely freed from their anxiety problems and interacting with people freely, in ways that were difficult for them previously.
Benzos depress the CNS. They increase inhibitory nerve cell signaling in the brain, thus helping to relieve tension and anxiety.
Benzo examples include:
When used as the doctor recommends, which means sticking to a tight prescription protocol, benzos are beneficial, and they are effective in relieving tension and anxiety. However, if abused just so, the euphoric effects can be experienced, dependency, tolerance and addiction result, and withdrawal symptoms will set in if the drug's cessation is done.
Cocaine is a stimulant drug. It influences the brain's reward system by effectively blocking dopamine's flushing from the brain's synapses. This is what sets in place the foundations for compulsive use patterns. By and by, physiological dependency sets it.
When you cease to use cocaine, you may experience a very severe mood rebound. You will feel ultra-flat - even depressive - and will crave the drug so that you can lift yourself from the low mood. Withdrawal symptoms set in fast - typically hours after the last dose - as cocaine leaves the system quickly.
Withdrawal from cocaine is rarely physically dangerous. However, the symptoms may be depressing. They include:
Stimulant withdrawal differs from withdrawal from other substances in that physical symptoms are so very few. As such, withdrawal from a stimulant like cocaine is not considered life-threatening.
Alcohol is not usually thought of as a drug. However, alcohol truly is a drug. It is the most widely used and abused drug in the US. The other thing with alcohol use and abuse is that withdrawal symptoms resulting from cessation can be dangerous or even life-threatening. This is why one must not attempt going cold turkey, especially if addiction is already established.
Former alcoholics have been known to suffer seizures as well as multiple other uncomfortable symptoms. Alcohol withdrawal needs to be managed in a professional setting.
Alcohol depresses the CNS. This is why, after taking it, you will feel a lot less anxious. For this reason, alcohol is referred to as a social lubricant. Quitting cold turkey leads to dangerous CNS excitation as the body goes into overdrive, in its attempts to restore equilibrium.
Withdrawal symptoms will typically show up mere hours after the last drink. Some of the more severe symptoms may remain a factor for up to 3 days. Here are some symptoms you can expect upon quitting:
Withdrawal is challenging. If you are considering getting sober, the smart play is to approach a rehab center. Some rehab centers have detox units. Those who do not may first refer you to a detox center so that the drug can be flushed.
Withdrawal management is a large part of detox. It refers to the case, both medical and psychological, of former users experiencing withdrawal symptoms.
With most substances, medical detox will provide the fastest, most comfortable, most practical setting for managing withdrawal. At a detox center, no matter how uncomfortable the symptoms are, you are guaranteed safety. Medical professionals will monitor your vitals, your temperature, and even your blood pressure. They will also avail medications that will blunt the severity of the symptoms you are experiencing.
Medical professionals may administer varied medications, which will ease withdrawal symptoms and blunt the risk of complications.
1) Clonidine: This one is used to lessen moderate opioid withdrawal symptoms. It will be useful in cutting down the frequency and intensity of sweating, chills, vomiting, and insomnia.
2) Buprenorphine: This is FDA-approved. It is a partial opiate antagonist which is used for mild-to-severe opioid use disorder. It controls drug cravings and blunts withdrawal symptoms.
3) Methadone: This is a long-acting medication that stabilizes and maintains those in recovery from OUD.
To manage acute alcohol withdrawal, benzos are typically administered for seizure prevention and other symptomatic management. They are gradually tapered off as the detox period advances.
Various drugs have varied symptoms, timelines, and risks. As such, an one-size-fits-all approach is rarely ideal. The tailored treatment works better.
Medical detox is only the initial step. You will require to move into rehab after detox so that you can maintain sobriety and stay away from potential relapses. The encouraging part is that drug withdrawal will only be uncomfortable for a week or thereabouts in most cases.