Almost any substance that we consume in large amounts is going to result in a withdrawal period. This is true for caffeine, sugar, and processed foods. When our bodies grow dependent on these items, there is a period where it begins to adjust back to normal upon cessation. The same is true for drugs.
Because drugs change our brain chemistry, we go through a period in which the body acclimates to a lack of foreign chemicals when drug use stops. This process is called withdrawal, and it is defined as a set of typical signs and symptoms that usually result from either the sudden removal of or an abrupt decrease in the regular dosage of a drug. The signs and symptoms of withdrawal will vary significantly from one drug to the next.
Someone who has been under the influence of depressant drugs or medications tends to rebound with overstimulated symptoms during the period of withdrawal. At the other end of the spectrum, someone who has been taking excitatory drugs such as stimulants will experience rebound depression of physiologic function once the drug is stopped and withdrawal begins.
Because different drugs affect different areas of the brain, it’s evident that cocaine withdrawal is going to be different than benzodiazepine withdrawal. There are other factors at play as well, such as how long someone has been using drugs, their age, and how much they use. These are just some of the factors that go into withdrawal periods.
Acute withdrawal from drugs can be an extremely unpleasant experience, but in some cases, it can be dangerous. Those with the desire to stop using may think they don’t need help and can forgo the process on their own using a method known as “cold-turkey.” But this can lead to less than desirable outcomes. If you are serious about sobriety, it’s important to take the proper steps to not only ensure your safety but secure the best possible outcome for long-term abstinence. Below, we examine the drugs with the most extended withdrawal periods.
Heroin and prescription painkillers fall under the opioid class of drugs. Narcotic analgesics are painkillers derived from the seed pod of the poppy plant. Opioids are some of the most addictive substances on this planet, and even using the drug as prescribed can still lead to addiction. While withdrawal from the drugs is not inherently dangerous, it ranks as one of the most uncomfortable withdrawal periods of any drug. Common symptoms of opioid withdrawal include:
While the drug has left your system and the acute withdrawal symptoms begin to subside after about a week, there is another part of the process you are going to experience. Post-acute withdrawal syndrome (PAWS) is a phase of withdrawal that can last weeks, months, and in some cases, years. PAWS is a constellation of brutally uncomfortable symptoms that persist when all traces of the drug have left the system. Long-term opioid use is notorious for PAWS, and symptoms can include impairment of energy, concentration, attention span, memory, sleep, appetite, and mood. The most common is increased depression, anxiety, and anger.
The active ingredient found in OxyContin and Percocet is a powerful synthetic opioid, and withdrawal can occur in as little as eight to 12 hours after the last use. The physical withdrawal symptoms of oxycodone peak around 72 hours, but they can last up to a full week. It is on a case-by-case basis, and what determines the length of withdrawal is how long someone has been using the drug, how much they were taking, and the method of administration.
Heroin is one of the most powerful substances on this earth, and withdrawal from the drug can be especially brutal. Heroin is a short-acting opioid and can take effect almost immediately depending on the route of administration. The effects of heroin peak in one to two hours and wear off around three to five hours. Heroin withdrawal can occur in as little as five hours, and last up to a week. The physical symptoms begin to taper off around five to 10 days. Heroin withdrawal may differ from person to person in severity, duration, and symptoms.
Benzodiazepines fall into a class of drugs known as central nervous system (CNS) depressants, and they decrease brain activity. They are often referred to as sedatives or tranquilizers and are notorious for how dangerous they are during withdrawals. Someone that is serious about stopping benzo use needs to attend a treatment center to mitigate the dangers involved with this type of detox. The withdrawals can be dangerous and include:
Post-acute withdrawal syndrome is a common part of benzo withdrawal and can last several months as the body adjusts to creating its own gamma-Aminobutyric acid (GABA). PAWS can last weeks to years and requires ongoing therapy to cope with symptoms as they slowly begin to subside over time.
Xanax withdrawal symptoms can take hold within a few hours of the last dose and can peak in severity within one to four days. Due to the severity of symptoms of Xanax withdrawal, a tapering schedule supervised by a medical detox team is necessary. General symptoms last one to four days and acute symptoms will peak around week two and begin to subside.
Valium withdrawal can last three to four days, but in some cases, someone can experience a more lengthy withdrawal phase that will continue 10 to 14 days. There will be a period of rebound anxiety between 10 and 14 days.
Central nervous system stimulants work by increasing levels of certain neurotransmitters within the brain. The drugs stimulate receptors that cause alertness, increased attention, and energy. Stimulant withdrawal is not dangerous, but it can leave the user unable to sleep for days and experience uncomfortable symptoms. During detox, clinicians will often prescribe depression medications to help alleviate depression. Other withdrawal symptoms include:
Post-acute withdrawal syndrome from amphetamines can last up to a couple of years. Because of how amphetamines affect the reuptake of dopamine in the brain, it can take a long time for someone to rebound from long-term amphetamine use. It has been said that someone dealing with PAWS from amphetamine have difficulties enjoying life because the levels of dopamine are not the same as they were before using the drugs.
There are three phases in cocaine withdrawal, the first consists of a crash that occurs after stopping the use of cocaine which can last a few days. During this stage, intense feelings of depression and anxiety can become present. Phase two, which is the withdrawal period, can last up to 10 weeks which is comprised of increased cravings, irritability, and periods of fatigue. The last phase, which is known as the extinction phase, is where individuals will still experience cravings. This is evident when they are exposed to triggers that remind them of their cocaine use.
Methamphetamine has a half-life of between six to 34 hours, and withdrawal can begin anywhere from one to five days and last up to eight days. Methamphetamine withdrawal can be very uncomfortable to deal with, and someone who is coping with withdrawals can experience aches and pains, depression, impaired social functioning, and persistent symptoms that remind them of using. Much like cocaine, withdrawal symptoms from methamphetamine can last several years depending on how long the drug was used.
Detoxing after Detox: The Perils of Post-Acute Withdrawal. (n.d.). from https://www.psychologytoday.com/us/blog/some-assembly-required/201505/detoxing-after-detox-the-perils-post-acute-withdrawal
The amphetamine withdrawal syndrome. (n.d.). from http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-3~drugtreat-pubs-modpsy-3-7~drugtreat-pubs-modpsy-3-7-aws