As you may have noted in my “Disclaimers” section, I am not a doctor. I will provide a simplified explanation of withdrawal for those who would like the “cliff-notes” version. Also, detox is safest when attempted in a medical setting. Withdrawal “cold turkey” can lead to serious complications, including death.
Withdrawal occurs when a person who is physically dependent upon a substance reduces or stops the use of that substance. Withdrawal is actually a result of the body and brain going into shock; it is as if the body and the brain are “screaming out” for the substance on which they have come to rely. At this point, the DRIVE of addiction has kicked in, and the brain actually “believes” that use is key to survival (see the section “Drive, Not A Choice” to read more specifically about this). It is as if the person is in a state of deprivation and use is key to their survival.
If you are wondering what symptoms you or your loved one might experience in withdrawal, this is somewhat easy to figure out. Think about what is experienced when the substance is used and then consider the opposite effect. This will be your withdrawal experience. The severity of the withdrawal will depend on the length of time and amount of substance used.
DOPAMINE AND WITHDRAWAL
Every addictive substance causes a flood of dopamine, the pleasure chemical, to enter the brain (other neurochemicals are involved as well, but dopamine is the main one). This dopamine flood causes what may be described as the euphoria, “high”, or feelings of relaxation or contentment. However, once withdrawal occurs (withdrawal can start once a person stops taking in the substance and it begins to break down in the system) dopamine levels drop. With a reduction in dopamine comes a reduction in pleasure, and the result is depression.
Over a long period of continued use (weeks, months, years), the brain attempts to regulate the neurochemical system. If the brain could talk it might say, “there is way to much of this chemical dopamine coming in, so we’d better cut production!” After all, there is an over-abundance of the chemical flooding the brain. Therefore, with continued use and continuous increased dopamine levels, eventually the brain stops making dopamine. Again, no dopamine = no pleasure. This absence of pleasure explains why so many people who struggle with addiction problems consider, attempt, or complete suicide.
A person might think that once they stop using the substance that dopamine production will simply start again (in other words, thinking “I just need to go to detox and get these chemicals out of my system”), but this is not the case. Much of the latest research shows it takes about 90-days for the brain to jump-start the healing process. Depending on the length of time in active-addiction, the brain may not return to “normal” functioning for a period of 6-months to several years. Even then, a person can experience a return of cravings (which may feel like a return of withdrawal symptoms) for the substance for the rest of their life.
Sedatives and alcohol are depressants, meaning they depresses – or slow down – the system (yes, they also cause depression). Alcohol/sedatives relax the body when consumed; therefore, in withdrawal they create the opposite of relaxation: anxiety, tremors, sweats/chills, and (possibly, depending on the amount used) the extreme opposite of relaxation: seizure.
COCAINE, CRYSTAL METHAMPHETAMINE, OTHER STIMULANTS
The use of stimulants leads to an immense, fast-acting rush of pleasure, stimulation, or energy — oftentimes in the form of mania. Therefore, the “crash” period that occurs after about 9-hours post-use is as equally potent in terms of the devastating depression that occurs. The early-onset symptoms include: agitation, depression, loss of appetite, and intense craving for more of the substance. Over time, fatigue sets in. Longer-term withdrawal symptoms are anhedonia (defined as an inability to feel pleasure), and sometimes paranoia, anxiety, and again intense craving.
MARIJUANA (and other Hallucinogens)
Many believe that marijuana is “natural” and therefore a fairly benign drug. However, this is a myth. After all, almost all of the major drugs of abuse come from natural plants. Alcohol is made from fermented fruit; cocaine comes from the coca leaf, and heroin from the opium poppy. All of those substances have proven themselves to be anything but benign. Marijuana has too.
Due to the lack of awareness about marijuana being addictive, it is no surprise that marijuana withdrawal is also misunderstood. Symptoms of withdrawal from marijuana include: irritability, anxiety, physical tension, decrease in appetite and mood, stomach pain, restlessness, anorexia (lack of appetite), insomnia, increased aggression/anger, and strange dreams. Withdrawal symptoms can last for a period of 45 days or longer.
OPIODS/OPIATES/NARCOTICS (including Methadone)
The actual withdrawal from all opiates is similar; however, the time it takes for the toughest symptoms to begin depends on how short-acting or long-acting the drug is. An opiate like Fentanyl is short-acting and leaves the body faster, so withdrawals should begin 8-16 hours after the last dose, whereas Methadone withdrawal is delayed due to the fact that Methadone is a long-acting drug. Since opiates work on changing our perception of our pain, the withdrawal from opiates will lead to an increased perception of pain, flu-like symptoms, anxiety, craving, muscle twitches and leg cramps, and insomnia.
For a complete list and explanation of withdrawal symptoms, click these links below:
Alcohol withdrawal: http://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome
Note: Withdrawal from alcohol or sedatives can cause serious complications or death, so it is best if a person addicted to these substances seeks medical assistance with detox.
Benzodiazepine withdrawal: http://en.wikipedia.org/wiki/Benzodiazepine_withdrawal_syndrome
Methadone withdrawal: http://en.wikipedia.org/wiki/Methadone_withdrawal_symptoms#Withdrawal_symptoms
Post-acute withdrawal symptoms are the symptoms that begin after acute withdrawal (or, after the initial more intense withdrawal symptoms subside). Post-acute withdrawal symptoms include: mood swings, anxiety, irritability, fatigue, variable energy, low enthusiasm, variable concentration, disturbed sleep, muscle spasms and soreness, and depression. Post-acute withdrawal symptoms can last 2 years or longer.
I’ve created a list of a variety of different ways to cope with post-acute withdrawal symptoms. Click here to see it: post-acute withdrawal coping