What Is Withdrawal?

Withdrawal, or substance withdrawal, is a process the mind and body go through after a person stops consuming a substance or consumes less of the substance. In general, people who consume more of a substance and more often are most likely to suffer from withdrawal. People who have previously gone through withdrawal, have a substance use disorder, or have a mental health condition are also at an increased risk.

Roughly 8.5 million adults suffer a mental health disorder and a substance use disorder at the same time in the United States. Withdrawal symptoms range from mild to severe. For example, it could just be a headache or difficulty sleeping, or it may result in death.

This article will review the causes, symptoms, and treatment of withdrawal for a variety of substances.

Causes

When a person uses a substance regularly, the body and mind get used to that substance. Initially, the substance will throw off the balance in the body, but then the body will adjust to the substance and register it as normal. This leads to a tolerance of the substance, which is when the body does not respond the same way unless the amount consumed is increased.

The processes of becoming tolerant, dependent, and addicted involve changes in the brain. Neurotransmitters are chemical messengers in the brain and body that send messages between cells. This is how the body and brain communicate to allow a person to think, feel, act, and experience the environment.

Substances can change the way neurotransmitters function, which changes the way substance users think, feel, act, and experience the environment. Depending on the substance, neurotransmitter activity can increase or decrease. With regular substance use, the changes become the new normal. When the substance is stopped or decreased, the person experiences withdrawal.

Withdrawal Symptoms by Drug Type

Some symptoms of withdrawal are common to a variety of different substances. However, withdrawal symptoms can vary by substance. It is important to know the withdrawal symptoms specific to a particular substance. Additionally, the severity of the signs and symptoms may depend on how much of the substance was taken and how long it was used.

Alcohol

Most alcohol withdrawal symptoms resolve within several days, but they can last longer. Symptoms can include agitation, anxiety, decreased energy, delirium, dizziness, emotional outbursts, fever, feeling disoriented, hallucinations, headaches, increased blood pressure, insomnia, irritability, memory loss, nausea, seizures, shaking, sweating, tremors, and vomiting.

Alcohol withdrawal is very serious and could lead to death, so it is important to seek professional help when decreasing or stopping alcohol consumption.

Antidepressant

Withdrawal symptoms of suddenly stopping certain antidepressants include anxiety, chills, difficulty sleeping, dizziness, headaches, increased depression symptoms, irritability, muscle aches, nausea, sensations of electric shock, sleepiness, and vivid dreams. These symptoms can last a few weeks. Symptoms can be severe, including a return of symptoms of depression, so it is important to talk with a doctor before stopping these medications.

Benzodiazepine

Withdrawal symptoms of benzodiazepine include anxiety, cravings, delirium, depression, difficulty sleeping, hallucinations, headache, heart palpitations, panic attacks, seizures, stiff muscles, sweating, tension or irritability, and tremors. Symptoms can last up to a few weeks. Benzodiazepine withdrawal can lead to death, so it is important to seek professional support for this substance.

Caffeine

Caffeine withdrawal symptoms include headaches, irritability and other mood changes, nausea, sleepiness, painful muscles, and trouble with concentration. These symptoms can last over a week. Symptoms of caffeine withdrawal range from mild to moderate.

Marijuana

Although marijuana is commonly believed to not be harmful, 47% of people who use the substance regularly experience withdrawal symptoms. These symptoms include abdominal pain, aggression, anger, anxiety, changes in appetite or weight, depression, difficulty sleeping, headache irritability, nausea, nervousness, restlessness, sweating, and vomiting.

Marijuana withdrawal symptoms usually last a couple of weeks, but some may remain for several months. The severity of symptoms can range from mild to severe, and it is important to seek professional support for the emergence of symptoms such as depression.

Nicotine

Nicotine withdrawal symptoms include urges to smoke or use tobacco products, negative changes in mood, restlessness or jumpiness, difficulty concentrating, sleeping difficulties, weight gain or hunger, anxiety, and depression. The withdrawal symptoms tend to be worse in the first week but can last several weeks after quitting.

While most symptoms of nicotine withdrawal are not life-threatening, depression and other mental health concerns that may occur are linked to suicide. Therefore, it is important to seek professional support if any mental health concerns emerge when going through nicotine withdrawal.

Opioid

Symptoms of opioid withdrawal include aches and pains, agitation, anxiety, cramping, diarrhea, difficulty sleeping, goose bumps, increased heart rate or blood pressure, nausea, pupil dilation, sweating, vomiting, watering eyes or dripping nose, and yawning. These symptoms can range from mild to severe and can last a few days to a few weeks. Opioid withdrawal can lead to potentially serious medical complications and relapse, so it is important to seek professional support.

Stimulant

Stimulant withdrawal symptoms include anxiety, changes in appetite, depression, difficulty focusing or concentrating, difficulty sleeping, dizziness, fatigue, headaches, irritability, and mood swings. Symptoms can last for a few days to a few weeks, or longer in some cases. They can range from mild to severe. It is important to seek support for withdrawal symptoms such as depression, especially if there are suicidal thoughts.

Treatment

Seeking care from a qualified healthcare professional is an important step before reducing or stopping substances. This can help to prevent or minimize symptoms of withdrawal. They are able to help determine the risk of severe symptoms and provide information, resources, and possibly other necessary treatment options.

Detoxification

Detox, or detoxification, is a process of supporting a person going through withdrawal to help them get the substances out of the body more safely.

Detox can be done at a clinic, hospital, or rehabilitation center and may include medications to manage withdrawal and help to reduce symptoms. After the detox process, continuing treatment with groups such as Alcoholics Anonymous or Narcotics Anonymous is recommended to keep you substance free.

Tapering

Tapering is a process of slowly decreasing the use of a substance, such as a prescription medication, over time to prevent withdrawal. Over-the-counter (OTC) medications are available to help decrease or stop using some substances. For example, nicotine patches and gum can be used to make it easier to stop smoking.

Prescription medications may also be used. For example:

• Partial opiate receptor agonist (buprenorphine) medications help to block opioid withdrawal symptoms and cravings
• Benzodiazepines to manage alcohol withdrawal
• Adrenergic receptor agonist medications help to reduce symptoms of opiate withdrawal
  

Summary

Withdrawal is a reaction of the mind and body that happens when a person reduces or stops using a substance. Symptoms can range from mild to severe, and withdrawal may even result in death. It is important to seek help from a qualified healthcare professional before reducing or stopping substances and to treat withdrawal symptoms.

A Word From Verywell

Withdrawal may come with many emotions and fears, and it can be difficult to ask for help. If you or someone you know is struggling with substance use or withdrawal, you are not alone. Reach out to a healthcare professional for support. If you are not sure where to turn, the SAMHSA Helpline is a great resource.