Frequently Asked Questions
- What is Withdrawal & How Long Does It Last?
- What Are Typical Symptoms of Withdrawal?
- What is Post-Acute Withdrawal Syndrome (PAWS)?
- Which Drugs Cause Withdrawal?
- Is Quitting Alcohol Cold Turkey Dangerous?
- Is Withdrawal Deadly?
- How Do I Successfully Withdraw from Drugs and/or Alcohol?
- What Is Drug and Alcohol Withdrawal Treatment?
- Is Medical Detox Recommended for Withdrawal?
What is Withdrawal & How Long Does It Last?
Withdrawal refers to the symptoms that are experienced following an abrupt reduction in or discontinuance of a long-term abused substance.1,5 Symptoms can vary significantly based on a number of factors including age, length of use, physical health, and prior history of severe withdrawal; depending on the substance(s) involved and the associated magnitude of physical dependence, withdrawal effects can be mild to life-threatening.
Acute withdrawal symptoms are commonly experienced for several days to weeks, though the timeframe for some withdrawal syndromes, from start to finish, may be quite protracted (lasting months or years).
What Are Typical Symptoms of Withdrawal?
Withdrawal symptoms can vary widely based on the substance type being abused.2,3 Common symptoms include, but are not limited to:
- Difficulty thinking clearly.
- Sleeping problems.
- Loss of appetite.
- Rapid heartbeat.
What is Post-Acute Withdrawal Syndrome (PAWS)?
For most substances, acute withdrawal symptoms begin within a few hours or days after last use and generally resolve within a month.4 In some cases, post-acute withdrawal symptoms (PAWS) may arise and persist well beyond a more typical acute withdrawal period. The character of and timeline for PAWS symptom presentation may differ based on a variety of factors. In general, symptoms may include sleep issues, anxiety, cravings and depression. PAWS symptoms are commonly less severe/dangerous than some acute withdrawal symptoms, though they may present significant recovery challenges in the long-term.
Which Drugs Cause Withdrawal?
While some drugs, such as the classic hallucinogens (e.g., LSD, DMT), are not associated with significant withdrawal effects, several illicit and prescription drugs will give rise to some troublesome symptoms when stopping or minimizing use.2 Commonly abused stimulants such as cocaine and methamphetamine do have an associated withdrawal syndrome (with predominantly mental/emotional symptoms), yet withdrawal associated complications are relatively rare. A higher risk for severe and/or complicated withdrawal is seen with central nervous system depressants such as alcohol, benzodiazepines (e.g., Valium, Klonopin), and barbiturates (e.g., phenobarbital, butalbital).6
Is Quitting Alcohol Cold Turkey Dangerous?
If a person with a long-term, heavy alcohol use quits drinking cold turkey, they may experience severe symptoms of withdrawal. Typically, acute alcohol withdrawal symptoms develop within 8 hours after the last drink and peak in severity between 24 to 72 hours. However, the more alcohol that has been consumed (i.e., a history of frequent and excessive drinking) equates to an increased likelihood of significant physical alcohol dependence and a corresponding greater chance of potentially-dangerous withdrawal complications.7 In its most severe presentation, a condition known as delirium tremens (DTs) may develop over the course of the acute alcohol withdrawal period; the DTs may include symptoms such as fever, agitation, hallucinations, and seizures.2 If unsure of the level of detox care that may be needed for you or a loved one, seek professional medical assistance to avoid potential life-threatening complications.
Is Withdrawal Deadly?
Even at its mildest, withdrawal can be uncomfortable and bothersome. In worst cases though, it can be life-threatening. But not everyone will experience severe withdrawal when quitting drugs or alcohol, since the nature of withdrawal effects will vary by substance type and an individual’s length and amount of use, medical history, and previous withdrawal experience.2 Substances associated with the most potential for severe or complicated withdrawal include alcohol, sedatives, and opioids. Additionally, a history of polysubstance abuse involving one or more of these substance types may also place you at heightened risk of a markedly unpleasant, potentially lethal withdrawal. Because quitting certain substances abruptly can put your life in danger, entering a professional detox program with qualified medical staff can ensure a safer, more comfortable withdrawal experience.
How Do I Successfully Withdraw from Drugs and/or Alcohol?
Although not every person will go through withdrawal when quitting substance use, it’s good to speak with a medical professional prior to detoxing for an expert evaluation of your level of substance dependence, withdrawal risks, and to better understand what level of care may be necessary to keep you safe and comfortable in early recovery. Detox programs help people safely withdraw from drugs and alcohol in a supportive environment and, in some cases, are critical to avoiding more serious withdrawal complications.
What Is Drug and Alcohol Withdrawal Treatment?
Medical management of drug and alcohol withdrawal often takes place at the start of a longer period of substance abuse rehabilitation treatment. This type of early treatment intervention helps minimize the discomfort of those going through withdrawal and can help safely prevent more serious complications. Treatment can vary in levels of care and can be performed in variety of settings. A doctor or other treatment professional may evaluate the individual prior to recommending an appropriate level of care to safely manage acute withdrawal.
Is Medical Detox Recommended for Withdrawal?
With certain substances—or for persons with heavy, long-term drug or alcohol abuse—medically-managed detox may be recommended in order to ensure the safest, most comfortable environment for the individual. For people at high risk of a severe or complicated withdrawal, having medical staff present to supervise the detox process—and to make appropriate medical interventions, when needed—is essential to avoiding life-threatening situations.
. National Institute on Drug Abuse. (2017). Frequently Asked Questions.
. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
. National Institute on Drug Abuse. (2018). Commonly Abused Drugs Chart.
. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal. HHS Publication No. (SMA) 9(1), 10-4554.
. U.S. National Library of Medicine. (2016). Opiate and opioid withdrawal.
. Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian prescriber, 38(5), 152–155. doi:10.18773/austprescr.
. U.S. National Library of Medicine. (2017). Alcohol withdrawal.