Withdrawal and Detox

What can you expect during withdrawal and detox?  After watching movies like the 90s classic Trainspotting in which characters suffer the frightening effects of withdrawal from drugs, you may be  wondering how closely those films reflect reality.  You may wonder how much doctors can do to help people with addictions go through detox.  Is it safe to try to detox on your own? 

Whenever people who regularly use drugs or alcohol and become physically and/or psychologically dependent on them abruptly stop using that substance, they will experience withdrawal—which refers to a variety of predictable symptoms specific to the substance that they have been using.   Detoxification is the process of ridding the body of drugs or alcohol as safely and quickly as possible while alleviating the symptoms of withdrawal.  Because the symptoms of withdrawal range from irritating physical complaints to life-threatening conditions, detoxification should occur under the care of a physician, who can prescribe medications to ease the most severe effects of withdrawal.  While some people may be able to undergo detoxification without being admitted to a hospital or other treatment center, others will need to be admitted in order to detox safely. 

Why does withdrawal happen?

When a person repeatedly uses drugs or alcohol, they develop a tolerance for that substance.  In other words, the chemistry of their brain is altered, and their neurons begin to communicate differently by modifying the number and function of neurotransmitters and receptors.  When an alcoholic suddenly stops drinking without medical support, for example, their brain becomes highly overactive, which can cause seizures, memory loss, and, in the most severe cases, hallucination (delirium tremens).

What are the most common symptoms of withdrawal?  How are they treated during detox?

• Alcohol.  The most common symptoms of alcohol withdrawal include anxiety, depression, an inability to think clearly, fatigue, shakiness, nightmares, moodiness, and irritability.  The most extreme form of alcohol withdrawal, seen in very heavy drinkers, is a life-threatening condition called delirium tremens and can include shaking, vomiting, fast heartbeat, sweating, seizures, and hallucinations.  Detoxification typically takes 4–7 days, during which doctors will monitor the patient closely and prescribe sedatives to ease withdrawal.
• Stimulants, including methamphetamine and cocaine.  The symptoms of withdrawal often include fatigue, anxiety, depression, and severe cravings.  In extreme cases, suicidal thoughts, suicide attempts, paranoia, and psychosis may occur.  Treatment during detoxification involves emotional support and medications to alleviate depression or psychosis.
• Opioids, including heroin, morphine, and Oxycontin.  Withdrawal symptoms can be minor, including runny nose, anxiety, sweating, and cravings, or more severe, including insomnia, depression, vomiting, diarrhea, shaking, and bone and muscle pain.  Most symptoms last for a few days, but depression can last for several weeks.  Treatment may involve substitution therapy, in which doctors prescribe an opioid agonist like methadone or suboxone.

Remember – withdrawal from drugs and alcohol is a serious physical condition and requires the support of medical professionals.  In addition, becoming drug or alcohol free through detoxification is an extremely important first step in overcoming addiction, but it is only the beginning.  Detoxification must always be followed up with some sort of therapy and medication to help prevent relapse and to enable recovering addicts to continue in their new life.