What Is Withdrawal?

Withdrawal is the body and brain’s reaction when a person stops or reduces substance use after physical dependence has developed. Dependence means the body has adapted to alcohol or drugs and has difficulty maintaining balance without them.

Withdrawal and detox are related, but they are not the same. Withdrawal refers to the symptoms that happen after stopping or reducing use. Detox is the process of clearing substances from the body while managing withdrawal symptoms as safely as possible.

Withdrawal symptoms can range from mild to severe. They may include anxiety, sweating, nausea, tremors, insomnia, mood changes, cravings, confusion, seizures, or hallucinations. Medical support is especially important for alcohol withdrawal, benzodiazepine withdrawal, opioid withdrawal, and withdrawal from multiple substances.

What Happens To The Body In Withdrawal?

When an individual becomes physically dependent on a substance, the body adapts to the presence of the drug in the system. If they stop using suddenly, this can put the body under great strain and cause extreme discomfort. The body is trying to adapt to the absence of drugs that it has become dependent on. It is likely to make the individual very unwell with physical discomfort and significant psychological symptoms.

All substances have slightly different withdrawal effects depending on how the drug works on the brain, although they tend to share some similar symptoms.

Opioids, including heroin and prescription painkillers, work by affecting the brain’s neurotransmitter dopamine. Dopamine enables us to feel happiness and euphoria. After prolonged opioid use, the brain stops producing dopamine on its own and relies on the presence of the substance to feel good. After some time of addiction, the individual will no longer be able to produce adequate levels of dopamine naturally. When they stop using cold turkey drugs, they will likely feel symptoms associated with low dopamine, such as anxiety and depression.

Which Withdrawals Can Be Dangerous?

Some types of withdrawal carry higher medical risk than others. Alcohol and benzodiazepine withdrawal are among the most dangerous because they can involve seizures, delirium, and serious nervous system instability.

Opioid withdrawal is usually not fatal by itself, but complications can become dangerous. Severe vomiting, diarrhea, dehydration, relapse, and overdose after reduced tolerance can create life-threatening risks.

Withdrawal from multiple substances can be unpredictable. Symptoms may overlap, intensify, or hide one another, making medical detox and clinical monitoring especially important.

Severe Withdrawal Symptoms

Some drug withdrawal brings a higher risk for the individual. These can be physical or psychological risks. We look at some of these substances below.

Benzodiazepine Withdrawal

When individuals stop using benzodiazepine (benzos), they are at risk of experiencing grand mal seizures. Benzo withdrawal also carries significant psychological risk, leading to suicidal ideation and suicide. Some of these psychological symptoms include:

• Anxiety and depression
• Panic attacks
• Aggression
• Nightmares
• Disorientation
• Loss of identity

These severe symptoms can last from months to a year, but research has found that gradual dose reduction combined with psychological treatment results in successful rehabilitation for benzo substance abuse.

Opiate and Opioid Withdrawal

Narcotics are the group of drugs which opiates and opioids come under. Opiates are derived from the poppy plant, including opium, morphine, and codeine. In contrast, opioids are a substance that is synthetic or partly synthetic. They include oxycontin, hydrocodone, and fentanyl. Opioids act similarly to opiates in the human body because of their similar structure.

Opioid and opiate withdrawal symptoms include:

• Nausea, vomiting, and diarrhea
• Increased heart rate
• Increased blood pressure
• Anxiety
• Insomnia
• Muscle aches and twitches
• Dilated pupils

While these symptoms themselves are not life-threatening, dehydration from nausea, vomiting, and diarrhea can be dangerous for the individual, especially if left untreated. For this reason, a medical detox program and certified addiction treatment are strongly advised to manage opiate and opioid withdrawal symptoms and maintain abstinence from the drug.

Alcohol Withdrawal

Alcohol abuse is a widespread problem. Contrary to popular opinion, there are higher risks of fatal withdrawal symptoms from alcohol than from other drugs. There are some symptoms to be aware of if you or a loved one is embarking on alcohol withdrawal.

Delirium Tremens (DT) is the most dangerous aspect of alcohol withdrawal and can severely damage the brain and nervous system. In addition, it can lead to seizures and high fevers, which, in rare cases, can result in death.

Some alcohol withdrawal symptoms:

• Heart palpitations
• Seizures
• Hallucinations
• Delirium tremens

Research suggests that individuals withdrawing from alcohol should be treated in a quiet, calm environment. They also advise that individuals experiencing seizures or DT should have immediate intravenous drugs and fluids to manage the symptoms.

Multiple Addiction Withdrawal

For individuals living with multiple addictions, symptoms typically increase, which brings a greater risk of fatality or severe health problems. Numerous substance withdrawals can interrupt each other, causing complications for the individual, increasing the dangers without medical support. Specifically, the dangerous symptom of seizures is common in benzo, alcohol, and opiate withdrawal. If an individual is withdrawing from two of these substances, it increases the risk of fatal seizures.

Post-Acute Withdrawal Syndrome (PAWS)

Post-acute withdrawal syndrome is a condition that some people experience months after they stop using a substance. These symptoms, also known as PAWS, can cause extreme discomfort for those in recovery and increase the chances of relapse.

Symptoms include:

• Brain fog
• Memory problems
• Feeling extremely sensitive/reactive
• Numbness
• Sleep issues
• Disorientation
• Stress

Establishing healthy coping techniques and a clear schedule can alleviate your distress and prevent relapse. Proper sleep, a good diet, daily exercise, and avoiding stressful triggers are effective ways to reduce symptoms.

If you are concerned that you are experiencing PAWS, seek professional advice as soon as possible.

Risk of Relapse

There is an additional relapse danger for individuals who experience a cycle of using and detoxing. Every time an individual attempts detox, their symptoms will progress. This increases the chances of a more severe reaction, especially with alcohol withdrawal, as the seizure risk increases.

It’s crucial that individuals don’t try to detox alone and they have medical supervision to manage withdrawal symptoms and their effects.

The National Council on Alcoholism and Drug Dependence describes the need for monitored detox, particularly “[persons] who are unable to abstain with an absence of past withdrawal complications.”

Getting Help for Withdrawal and Addiction

Withdrawal can be physically and emotionally difficult, but medical support can make the process safer. People who are dependent on alcohol, benzodiazepines, opioids, or multiple substances should speak with a qualified professional before stopping use.

Cirque Lodge provides residential addiction treatment in a private setting in the Rocky Mountains. Care may include clinical assessment, detox planning, withdrawal management, therapy, dual diagnosis treatment, relapse prevention, family involvement, and continuing care planning.

Treatment helps each person stabilize, understand their addiction, build recovery skills, and prepare for life after treatment. For suspected severe withdrawal, seizure, delirium tremens, overdose, suicidal thoughts, or another medical emergency, contact emergency medical help immediately.