Drug and Alcohol Withdrawal Information
Withdrawal refers to a collection of symptoms, of varying levels of intensity or severity, that may accompany a marked reduction in use of certain psychoactive substances1.
When a person with significant levels of alcohol and/or drug dependence stops using these substances, they may experience uncomfortable symptoms and sometimes-lethal withdrawal complications. Depending on the magnitude of physical dependence, length of use, and specific type of substance, symptoms will vary in length and severity. Acute substance withdrawal may include both physical and physiological symptoms1.
Because specific substances are associated with different discontinuation syndromes, it’s important to understand how your body may react to quitting cold turkey. In cases of alcohol, benzodiazepines, and certain other sedating medications, medical supervision may be recommended to avoid potentially life-threatening situations2,3.
Below are some signs and symptoms of withdrawal for a handful of commonly-abused substances:
Signs and Symptoms of Withdrawal
Alcohol: Alcohol is one of the most commonly abused drugs in the world. Withdrawal symptoms can kick in within 6-48 hours of the last drink and can include insomnia, headache, fever, sweating, changes in heart rate and rhythm, rapid breathing, and tremors.4 A more serious constellation of symptoms is collectively known as delirium tremens (DT’s) which may manifest as hallucinations, confusion, autonomic nervous system excitation, and seizures.5 These symptoms can appear between 48 and 96 hours after last drink4.
Heroin: Heroin withdrawal symptoms may arise within 6-12 hours of last use and peak within 1-2 days after that.6 Though often exceptionally unpleasant, many symptoms begin to resolve within a week’s time. As part of the acute heroin withdrawal syndrome, you may experience irritability, anxiety, fever, chills, runny nose, loss of appetite, nausea, vomiting, stomach cramps, and generalized body aches/pains6.
Cocaine: Cocaine use results in rapid onset, relatively quick to resolve effects; some withdrawal may be felt shortly after last use—even when the drug is still present in the bloodstream.7 Symptoms may include agitation and restless behavior, fatigue, increased appetite, vivid and unpleasant dreams, feelings of discomfort, depression, or slow activity7.
Meth: Meth is a powerfully addictive stimulant drug and withdrawal occurs in 87% of long-term users who quit using.8 Common stimulant withdrawal symptoms include anxiety, irritability, depression, increased appetite, paranoia, psychomotor slowing and can last up to 48 hours after last use.8 More severe meth withdrawal symptoms such as prolonged depression or seizures may occur in those with significant levels of physical dependence.
Vicodin: Vicodin, a brand name combination of hydrocodone and acetaminophen. As with heroin, Vicodin in sufficiently high doses is capable of eliciting a rewarding, euphoric high and, over time, result in significant opioid dependence. Similarly, the withdrawal syndrome associated with both drugs will share some characteristic symptoms.6 Some symptoms of acute Vicodin withdrawal include irritability, muscle cramps, diarrhea, vomiting, nausea, sweating, fever, chills, and loss of appetite.6 Symptoms typically dissipate in 7-10 days.
Nicotine: For chronic nicotine users, withdrawal symptoms begin 4-24 hours following termination of use and peak around the third day.9 Typically, following 3-4 weeks of abstinence, symptoms begin to taper off. Some of the withdrawal symptoms associated with nicotine include increased appetite, insomnia, anxiety, depressed mood, irritability/anger/frustration, and difficulty concentrating9.
. World Health Organization. (n.d.). Management of Substance Abuse.
. MedlinePlus. (2019). Alcohol Withdrawal.
. Greenberg, Michael I. MD MPH. (2001). Benzodiazepine Withdrawal: Potentially Fatal, Commonly Missed. Emergency Medicine News, 23(12), 18.
. Bayard, M., Mcintyre, J., Hill, K.R., Woodside, J. Alcohol Withdrawal Syndrome. American Family Physician; 69(6): 1443-1450.
. Rahman A, Paul M. (2018). Delirium Tremens (DT). U.S. National Library of Medicine.
. MedlinePlus. (2019). Opiate and Opioid Withdrawal.
. MedlinePlus. (2017). Cocaine Withdrawal.
. Bradford T. Winslow, M.D., Kenton I. Voorhees, M.D., Katherine A. Pehl, M.D. (2007). Methamphetamine Abuse. American Family Physician; 76(8):1169-1174.
. McLaughlin, I., Dani, J. A., & De Biasi, M. (2015). Nicotine Withdrawal. Current Topics In Behavioral Neurosciences, 24, 99–123.
Most mind-altering drugs, including alcohol, cause severe, uncomfortable and even life-threatening withdrawal symptoms when an addict suddenly stops using them.
Drug and alcohol withdrawal treatment, which prevents symptoms caused by abrupt withdrawal of substances to which patients are physically addicted, is the first phase of substance abuse rehabilitation treatment.