Withdrawal Symptoms

For many, the journey towards addiction recovery begins with confronting the physical dependence on drugs and alcohol. This initial stage is marked by withdrawal, a process that occurs when an individual reduces or stops the intake of drugs or alcohol to which their body has become accustomed. Withdrawal is not merely a discomforting phase; it can be dangerous and, in extreme cases, life-threatening. Anyone who is planning on undergoing detox must understand that safe and effective withdrawal requires medical guidance and a full understanding of the potential side effects and symptoms.

Withdrawal explained

Withdrawal is the action of ceasing drug or alcohol use by a physically dependent individual and is also a term used to describe the series of symptoms that occur as a result. Physical dependence is a state where the body becomes so accustomed to the presence of a substance that it begins to rely on it for normal functioning.

When a person who is dependent on a substance reduces or stops its use, their body faces a sudden and significant imbalance. This imbalance triggers a variety of unpleasant effects, known collectively as withdrawal symptoms. The nature and intensity of these symptoms can vary greatly depending on the substance involved, the level of dependency and the individual’s physical and mental health.

Detox, short for detoxification, is the process designed to manage the withdrawal symptoms safely. It involves clearing the body of toxins and substances, thereby breaking the physical dependence and allowing the body to start healing from the effects of long-term drug or alcohol abuse. Professional medical detox is more than just abstaining from substance use; it is a medically supervised process that ensures the individual’s safety and prepares them for the next steps in addiction treatment and recovery.

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The dangers of withdrawal

Understanding the dangers of withdrawal requires a grasp of its chemical underpinnings. As explained above, when an individual repeatedly uses a substance, their body adjusts to its presence. This adjustment involves a complex interplay of brain chemicals and receptors, with the body starting to rely on the substance to maintain balance.

The dangers of withdrawal are particularly acute because the body, having adapted to the presence of the drug or alcohol, finds itself in a state of shock when the substance is removed. This shock can manifest in a range of symptoms, some of which can be severe or even life-threatening. For example, abrupt cessation of alcohol after heavy, prolonged use can lead to seizures or delirium tremens, a serious condition that can be fatal.

This is why attempting drug or alcohol detox at home by going “cold turkey” can be extremely risky due to the potential severity of withdrawal symptoms and the lack of medical supervision.

Common withdrawal symptoms

Withdrawal symptoms vary significantly depending on the substance abused, the duration of addiction and the individual’s physical and psychological health. Each substance affects the brain and body differently, leading to a unique set of withdrawal symptoms, which may include:

Ataxia during drug detox
Ataxia refers to a lack of muscle coordination that can affect speech, eye movements and swallowing ability. During drug withdrawal, especially from substances that affect the central nervous system, ataxia can be a common symptom due to the brain’s readjustment to the absence of the substance.
Dysphoria during drug detox
Dysphoria is a state of unease or generalised dissatisfaction with life that can manifest as feelings of depression, restlessness or irritability. In both alcohol and drug withdrawal, it often results from the brain’s struggle to rebalance its chemistry without the substance.
Convulsions during drug detox
Convulsions or seizures can occur during detox, particularly from alcohol or benzodiazepines. These convulsions are often the result of the body reacting to the sudden alteration in neurotransmitter activity.
Panic attack during drug detox
The removal of certain substances, especially those that depress the central nervous system, like alcohol and benzodiazepines, can cause heightened anxiety, leading to panic attacks. These are intense periods of fear or discomfort accompanied by physical symptoms like palpitations, sweating and shortness of breath.
Nausea during drug detox
Nausea is a common symptom in detox from many substances, as the body attempts to expel toxins and readjust to functioning without the drug.
Tremors during drug detox
Tremors or shaking, particularly in the hands, are common during detox, especially from alcohol. They result from nervous system hyperactivity as the body withdraws from the substance.
Respiratory depression during drug detox
Detoxing from certain substances, especially opioids, can lead to decreased respiratory rates. This happens because the respiratory system initially struggles to regain its normal rhythm, leading to potentially serious respiratory depression.
Delirium tremens during drug detox
Delirium tremens (DTs) is a severe form of alcohol withdrawal that includes sudden and severe changes in mental or nervous system function. Symptoms can include confusion, rapid heartbeat and high blood pressure.
Diaphoresis during drug detox
During detox, the body’s thermoregulatory system is disrupted, leading to diaphoresis as a response to the body’s effort to maintain a stable internal temperature. This excessive sweating can be particularly pronounced in withdrawal from opioids and alcohol, as these substances significantly affect the body’s heat-regulating mechanisms.
Insomnia during drug detox
Insomnia during detox is often caused by changes in brain chemistry, particularly in the neurotransmitters associated with sleep regulation. The absence of the abused substance, which might have been playing a role in sleep patterns, leads to difficulty in both falling and staying asleep, profoundly affecting the body’s natural sleep cycle.
Narcolepsy during drug detox
Narcolepsy, in the context of drug detox, especially after stimulant use, results from the brain’s disrupted sleep-wake cycle and its attempt to reestablish normal function. This can lead to sudden and uncontrollable episodes of falling asleep, even in potentially hazardous situations.
Sleep deprivation during drug detox
Sleep deprivation during detox is common due to disrupted sleep patterns and the brain’s adjustment to the lack of substances that may have been used to induce sleep. This lack of sleep can exacerbate other withdrawal symptoms and affect overall recovery.
Hypoventilation during drug detox
Hypoventilation occurs as substances like opioids suppress the respiratory system’s normal function, with withdrawal causing an abnormal slowing of breathing. This can result in decreased oxygen intake and increased carbon dioxide levels in the blood, posing serious health risks.
Concentration during drug detox
Detoxification often leads to difficulties in concentration as the brain adapts to functioning without drugs or alcohol. This can manifest as an inability to focus on tasks, disorganised thoughts and difficulty in processing information, all of which can lead to risky behaviour.
Confusion during drug detox
Confusion during detox is a direct result of the brain’s attempt to recalibrate itself in the absence of drugs or alcohol, affecting cognitive functions and memory. This can lead to disorientation, difficulty in understanding or retaining information and impaired decision-making abilities.
Anxiety during drug detox
Anxiety is a common drug and alcohol withdrawal symptom and a response to the body’s stress system overreacting as it copes with the absence of the substance. This often manifests in feelings of nervousness, worry and fear, which can be particularly intense in the early stages of detox as the body and mind struggle to adjust to the new state of sobriety.
Psychomotor agitation during drug detox
Psychomotor agitation is characterised by increased physical and emotional tension, often manifesting in pacing, hand-wringing and an inability to remain still. This symptom is particularly common in detox from stimulants, as the body adjusts to the lack of substances that were previously driving its activity levels.
Seizures during drug detox
Seizures during drug detox are serious and potentially life-threatening symptoms often occurring in withdrawal from alcohol and benzodiazepines. They occur due to abrupt disturbances in brain electrical activity and can require immediate medical attention to ensure the individual’s safety.
Benzodiazepine withdrawal syndrome
A complex array of symptoms, including severe anxiety, insomnia and the potential for seizures, characterises benzodiazepine withdrawal syndrome. This syndrome requires carefully managed medical intervention to mitigate risks and ease the benzodiazepine withdrawal process.
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A typical withdrawal timeline

The experience of withdrawal is unique to each individual, influenced by factors such as the specific substance used, the duration and intensity of addiction and their overall health. However, there is a general pattern or timeline that withdrawal symptoms tend to follow.

Initial phase

Depending on the substance, this phase usually begins within hours to a few days after cessation. Withdrawal symptoms can be mild to severe and often include physical symptoms like sweating, tremors and nausea, as well as psychological symptoms such as anxiety and agitation.

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Peak phase

Withdrawal symptoms typically reach their peak intensity in this phase. The timing varies – for some substances, it can be a few days after stopping, while for others, it might take longer. This is usually the most challenging phase, with symptoms like severe mood disturbances, sleep disturbances, psychological distress and physical discomfort.

Post-peak phase

Gradually, the intensity of symptoms decreases, with physical symptoms often lessening first and psychological symptoms persisting longer. The duration of this phase can vary widely, from days to weeks.

It is important to note that some individuals may experience what is known as Post-Acute Withdrawal Syndrome (PAWS) during detox. PAWS refers to a set of symptoms that persist well beyond the initial withdrawal period, sometimes lasting for months or even years. These symptoms are primarily psychological and emotional, such as ongoing depression, anxiety, mood swings and sleep disturbances. PAWS can be particularly challenging because of its prolonged nature and requires ongoing support and treatment beyond the initial detox phase.

The benefits of a detox programme for addiction

Overcoming an addiction through detoxification is not easy, but the safest approach is always under medical supervision. This can take place in a hospital or through a detox programme at a professional addiction rehab centre. These programmes offer several key benefits:

Medical supervision and safety

One of the primary benefits of a professional detox programme is the availability of medical supervision. Medical staff can monitor vital signs, manage withdrawal symptoms and respond quickly to any medical emergencies. This level of care ensures the safety and well-being of the individual throughout the detox process.

Management of withdrawal symptoms

Detox programmes provide medication and therapies to ease withdrawal symptoms, making the process more comfortable and manageable. This can include medication to reduce cravings, treat co-occurring mental health conditions and alleviate physical discomfort.

Foundation for long-term recovery

Successfully completing a detox programme sets a strong foundation for ongoing addiction treatment. It is often the first step in a wider rehab programme of therapy, lifestyle changes and aftercare. Being able to transition from detox to rehab within the same facility greatly reduces the risk of relapse and improves treatment outcomes.

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Support network

Being in a detox programme allows individuals to connect with others who are going through similar experiences. This can foster a sense of community and provide peer support, which is invaluable during recovery.

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Begin medically assisted detox today

If you or a loved one is struggling with addiction, it is crucial to seek professional help as soon as possible. Detox is a critical first step but can also be potentially dangerous, so make sure you take all the necessary precautions. Your GP, NHS Rehab and professional addiction treatment centres can all provide advice and access to medically assisted detox services, which are always the safest way to begin the journey to recovery.

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How long do withdrawal symptoms last?
Withdrawal duration varies based on factors like overall health, substance abuse history, co-occurring conditions, and response to detox. The level of professional medical support and the use of detox medications can also have an impact on the duration and severity of withdrawal symptoms as well as the overall chances of a successful detox.
What are withdrawal symptoms?
Withdrawal symptoms are the unpleasant sensations and effects experienced by individuals who stop using drugs or alcohol after developing a physical dependence on them. These symptoms can be physical, mental or emotional in nature and can range in severity from mild irritations to potentially life-threatening medical emergencies.
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