Drug and Alcohol Withdrawal Symptoms and Treatment
Many substances of abuse can lead to the development of physiological dependence—especially if they are taken in large amounts and for a long period of time. When a person becomes dependent on a substance and then decides to stop using it, they may be at risk of experiencing unpleasant addiction withdrawal symptoms.1
Individuals who have recently stopped taking their drug of choice may experience both physical withdrawal symptoms and mental side effects. The withdrawal process can be better navigated with the right help. If you or a loved one is struggling with substance use and wants to get help, it’s important to understand how drug and alcohol withdrawal symptoms can affect you. In this article, you will learn more about:
- Common withdrawal symptoms of drug and alcohol misuse.
- Causes of drug and alcohol withdrawal.
- Treatment for substance withdrawal symptoms.
- Medications for addiction treatment.
- Effectiveness of drug and alcohol treatment.
What Is Drug and Alcohol Withdrawal?
Drug and alcohol withdrawal involves the physical, mental, and behavioral changes that can occur after suddenly cutting back or stopping the prolonged use of substances.1, 2, 3 The effects of withdrawal from drugs are multifarious. The severity of addiction withdrawal can vary in association with different substances, but symptoms may be quite pronounced when people are attempting to quit alcohol and other substances such as opioids, benzodiazepines, and sedatives.3
Some people may wonder, “can I die from drug or alcohol withdrawal,” and the answer is yes. Withdrawal symptoms can be extremely dangerous, and can range from mild to potentially dangerous and severe. Symptoms such as seizures and disrupted regulation of body temperature, pulse, and blood pressure can be fatal outcomes from alcohol withdrawal.2 Medical detox can be a safe way to help manage the withdrawal symptoms of alcohol and drugs under the care of treatment professionals.3, 4
Causes of Alcohol and Drug Withdrawal Symptoms
The human body strives to be in a state of balance, known as homeostasis, and actively works to restore any imbalances that arise.5 Drinking and using drugs can greatly alter certain types of brain activity to disrupt normal homeostasis. Over time, when you use a substance regularly, your brain may make its own adjustments (i.e. neuroadaptations) to counter the chemical changes brought about by that specific substance.6
However, once you cut back or stop using, your brain may temporarily struggle to reach homeostasis again. It is this period of adjustment, which may involve a rebalancing of a number of chemical messengers known as neurotransmitters, that is thought to lead to withdrawal symptoms for several types of substances.5, 6
In other terms, these neuroadaptations resulting from continued drug or alcohol use lead to the development of physiological dependence. Dependent individuals grow so accustomed to the presence of a substance that they essentially rely on its continued use to feel and function normally.6, 7, 8 People with substance dependence are likely to experience some degree of the side effects of alcohol and drug withdrawal when attempts are made to slow or altogether stop their substance use.
What Types of Withdrawal Symptoms Are There?
Drug and alcohol withdrawal symptoms can range from mild to severe, depending on the substance being used.1, 3, 4 They also depend on how long and how heavily you’ve been using.1, 5 The withdrawal symptoms of drug abuse and alcohol addiction can be difficult to deal with and may lead people back to using their substance of choice in an effort to alleviate the discomfort.3
You can experience withdrawal symptoms with various types of substances, from marijuana and alcohol to stimulants such as cocaine and concerta, sedatives such as valium/diazepam, and opioids like subutex and heroin.3 Significantly severe signs of withdrawal are associated with substances such as alcohol, benzodiazepines like librium, and opioids.
Stimulants and marijuana are other drugs that are associated with potentially uncomfortable withdrawal syndromes, though the symptoms are often relatively less pronounced than those experienced during opioid, alcohol, and benzodiazepine withdrawal.3 The following sections provide more information about substance-specific types of withdrawal symptoms.
Alcohol Withdrawal Symptoms
You may be wondering, ‘how long does alcohol withdrawal last?’ Withdrawal symptoms from alcohol abuse can start anywhere between 6 to 24 hours after heavy, prolonged drinking is stopped. Symptoms can progressively worsen over the next 2–3 days, then will slowly improve until they are resolved by about the 10th day.3, 4 Some common signs and symptoms of alcohol withdrawal include:3, 4
- Rapid heart rate.
- Increased blood pressure.
- Nausea or vomiting.
- Hand tremors.
Acute alcohol withdrawal can be dangerous and potentially life-threatening.4 Severe signs of alcohol withdrawal can include agitation, seizures, and delirium tremens, which involves difficulty regulating body temperature and blood pressure, sweating, hallucinations, and confusion.3, 4, 5, 9, 10 Some of the symptoms of withdrawal from alcohol can be dangerous and could require immediate medical attention.4
Treatment for signs of withdrawal that includes medical detoxification and withdrawal management can help keep people as safe and comfortable as possible during the difficult drug and alcohol detox period of early recovery.
Benzodiazepine Withdrawal Symptoms
Benzodiazepines are central nervous system depressants commonly prescribed to manage anxiety, panic disorder, and certain seizure disorders.4, 8 Some examples of benzodiazepines include: 3, 4, 8, 11
Mixing benzodiazepines with opioids or other CNS depressants such as alcohol can lead to dangerous levels of sedation and respiratory depression, increasing side effects and the risk of a fatal overdose.8, 11, 12
Though the time of onset may vary, withdrawal symptoms following prolonged benzodiazepine abuse can appear within hours to days after stopping relatively short-acting benzodiazepines such as Ativan, or within several days to a week after you stop taking longer-acting benzodiazepines like Valium.3
Longer-acting benzodiazepines can have protracted withdrawal effects. Shorter-acting benzodiazepine withdrawal symptoms might take a few days to peak in intensity, with many symptoms then resolving within 4–5 days. Longer-acting benzodiazepines might lead to withdrawal symptoms that peak in the 2nd week and largely resolve by the 3rd or 4th week, though lower-intensity symptoms may linger in some individuals for several months and take up to 8 weeks to resolve.3 Potential signs of benzodiazepine withdrawal include:3, 4, 6
- Difficulty concentrating or remembering.
- Achy or tense muscles.
- Rapid pulse.
- Increased sensitivity to light, smells, and sounds.
Opioid Withdrawal Symptoms
Opioid addiction is commonly associated with opioid withdrawal symptoms when use is stopped.3 While opiate withdrawal symptoms aren’t typically life-threatening, there may be dangerous complications. For example, aspirating vomit into the lungs can lead to infection, and ongoing vomiting and diarrhea can cause dehydration and electrolyte imbalances.4, 13 Signs of opioid withdrawal include:3, 4, 5, 6, 13
- Dilated pupils.
- Excessive yawning.
- Runny nose.
- Watery eyes.
- Sweating and fever.
- Increased pain sensitivity.
- Achy muscles and joints.
- Nausea or vomiting.
Stimulant Withdrawal Symptoms
Stimulant abuse often occurs in patterns of heavy use (known as binges) followed by crashes, where use is stopped and withdrawal symptoms arise.3 Illicit central nervous system stimulants include crystal methamphetamine, cocaine, and crack. Some prescription stimulant medications such as methylphenidate (Ritalin) and dextroamphetamine (Adderall) are also subject to abuse.3, 4, 14
Stimulant withdrawal symptoms are typically not dangerous. Though rare, serious depression with suicidal thoughts or behaviors can be present during detox and should be monitored closely.6, 14 Signs of stimulant withdrawal can include:3, 4, 6, 14
- Depression or dysphoria.
- Increased appetite.
- Changes in sleep patterns—either excessive sleep or insomnia.
- Moving faster or slower than usual.
- Aching muscles.
- Strong cravings for the substance.
Marijuana Withdrawal Symptoms
Marijuana comes from dried parts of the Cannabis plant containing tetrahydrocannabinol (THC) and other psychoactive compounds.15 If you suddenly stop long-term, heavy use, even if it is medical marijuana, it’s possible you may experience signs of drug withdrawal for as long as 1 to 2 weeks. Common marijuana withdrawal symptoms include:3, 4, 6, 16, 17, 18
- Depressed mood.
- Cravings for marijuana.
- Upsetting dreams.
- Loss of appetite.
- Abdominal pain.
- Tremors or shakiness.
What Is Post-Acute Withdrawal Syndrome?
While addiction withdrawal symptoms are uncomfortable, they typically end after 2 weeks, especially with the help of medically managed detox. Some drugs, however, can lead to a protracted withdrawal process lasting for many months or even a year. People who consume a heavy amount of an intoxicating substance over a long period of time are more likely to develop this condition, known as Post-Acute Withdrawal Syndrome or PAWS.
Post-Acute Withdrawal Syndrome refers to symptoms that persist after acute withdrawal symptoms have resolved. PAWS symptoms, which rarely involve physical withdrawal symptoms, can be just as intense as those experienced during acute substance withdrawal. People may experience irritability, anxiety, depression, mood swings, low energy, insomnia, lack of focus, and a lack of libido. Post-Acute Withdrawal symptoms can put a person at risk of relapse, since they may return to drug use in order to put an end to the discomfort.
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Rehab Treatment for Drug and Alcohol Withdrawal Symptoms
Professional detoxification and withdrawal management—as opposed to detoxing from home—can provide medical and mental health care for people who are going through symptoms of withdrawal from drugs and alcohol.4, 19 Medical and psychiatric support and monitoring are available alongside drug and alcohol withdrawal treatment so that any physical and mental health symptoms can be addressed as needed.4, 9, 19 In some cases, medications may be used to ease symptoms of withdrawal and prevent complications arising during medically managed withdrawal.9
Withdrawal symptoms, potential risks, and available treatments vary by substance, so the type of withdrawal management you receive will differ accordingly.9 If you are planning to cut back or stop using a substance, you should consult with your doctor or an addiction treatment professional to discuss the risks and determine the safest and most effective form of withdrawal management for you.
What Is a Detox Program?
Detoxification programs primarily focus on getting you through the withdrawal process safely and comfortably. Though an important step, detox often does little to address the underlying psychological, behavioral, and social issues that contribute to addiction.2 Detox is only the first stage in the alcohol recovery process and should be followed up with additional forms of treatment in order to be most effective.2, 4
What Are the Types of Drug and Alcohol Addiction Treatment Programs?
Continuing addiction treatment after withdrawal management, or detox, is an important step toward long-term recovery.9, 13 As you get close to completing detox, your treatment team will discuss a longer-term treatment plan that best suits your needs and will help facilitate your entry into additional treatment, whether it be in the same location as the detox program or elsewhere.
In follow-up treatment programs, you can learn coping skills and relapse prevention techniques, improve your communication skills, and receive medication treatment, if needed.9
Treatment that may include substance withdrawal can occur in a variety of settings, depending on your needs and the intensity of your symptoms.2, 8 There is a continuum of treatment settings in which detox and rehab services are available, including:2, 20, 21, 22
- Outpatient treatment: A person can live at home and continue working while receiving treatment. This typically involves less than 9 weekly hours of treatment.
- Intensive outpatient: A person can live at home and continue working while receiving treatment for complex needs such as co-occurring or dual diagnosis mental health conditions. This type of treatment typically involves 9 or more weekly hours of treatment.
- Partial hospitalization: A person can live at home and continue working while receiving treatment for multidimensional instabilities. This typically involves at least 20 weekly hours of outpatient treatment.
- Residential treatment: A person lives at the treatment facility to receive 24-hour support from medical, mental health, and addiction treatment professionals. This typically involves a minimum of 5 weekly hours of clinical care.
- Medically managed inpatient drug and alcohol treatment: A person receives 24-hour nursing care and daily care from a physician to address severe and/or unstable problems. This level of care involves 24/7 medical monitoring, plus the availability of counseling staff for up to 16 hours a week.
As you move through drug and alcohol recovery, your treatment plan may need to be reevaluated and adjusted to meet your needs, as they may change.9 Additionally, longer periods of any form of addiction treatment (3 months or more) may be most helpful in reducing drug or alcohol use and improving treatment outcomes.9
Find Addiction Treatment Programs
Dealing with substance abuse and withdrawal is difficult and can be overwhelming. Addiction can have a profound impact on family and friends, as well as on the person suffering. Rehab centers are located throughout the U.S., and a variety of treatment types is available. You can use SAMHSA’s Find Treatment tool to search for facilities. Many state government websites will provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’
You may have questions about alcohol and drug withdrawal symptoms and treatment, and American Addiction Centers (AAC) is here to help. AAC is leading provider of addiction treatment programs and has trusted rehab facilities across the country. Our compassionate admissions navigators are available 24/7 to help you understand treatment options, including where you can receive withdrawal management for the unpleasant symptoms of coming off substances. Please call us free at to learn more. You can also check your insurance coverage online now to find out what treatment you qualify for.
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Health Insurance Providers That May Cover Addiction Treatment
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