Everything You Need to Know About Withdrawals
One of the first steps in addiction recovery can also be one of the worst: withdrawal. After someone stops or significantly decreases their use of a psychoactive substance, the body goes into acute withdrawal. Acute withdrawal is what is referenced when someone refers to “withdrawal.” The signs and symptoms associated with acute withdrawal typically begin within hours or days after the substance was last used. Acute withdrawal can last anywhere from 5 days to 5 weeks, depending on the substance(s) they were using. Time frames are outlined in the table below.
When signs and symptoms experienced during acute withdrawal persist, evolve, or appear well beyond what is generally expected, it is known as protracted withdrawal. Protracted withdrawal has been observed and reported where symptoms are experienced well past the acute withdrawal stage, however, research on the topic is limited. As such, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not include protracted withdrawal diagnoses nor time frames.
Protracted withdrawal symptoms vary based upon the substance that was being used.
- Protracted withdrawal symptoms for opioids include: anxiety, depression, and sleep disturbances that last for weeks or months, and fatigue, dysphoria, and irritability.
- Symptoms for methamphetamine include deficits in executive control functions. Cocaine protracted withdrawal symptoms are observed as impulse control issues and emotional regulation programs. However, significant improvement was seen for the latter after 4 weeks of abstinence.
- Symptoms relating to marijuana include sleep difficulties and strange dreams that persisted at least 45 days into abstinence.
- And finally, protracted withdrawal symptoms for benzodiazepines is a bit more difficult to diagnose than the rest because it mimics other disorders like agitated depression, panic, OCD, or generalized anxiety.
Not everyone will experience protracted withdrawals. It’s also possible for people to experience an initial relief of symptoms for the first month or so of abstinence, and then develop the symptoms again. The intensity of these symptoms differ from person to person.
While no one wants to go through withdrawals, it is helpful to know what is to come so you can prepare. It can also help you relay information to your therapist and/or psychiatrist to better assist them in treating you.
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Center for Substance Abuse Treatment. (2010). Protracted Withdrawal. Substance Abuse Treatment Advisory, Volume 9, Issue 1.