Stages of Drug Withdrawal

Learn about the stages of drug withdrawal and how to alleviate withdrawal symptoms effectively.

Table of Contents

What Is Drug Withdrawal?

Drug withdrawal is the body’s physiological reaction to the abrupt cessation or reduction of a substance on which it has become reliant. Withdrawal is essential for recovering from addiction. The severity and withdrawal symptoms vary depending on the substance and level of dependency. Stages of drug withdrawal include acute withdrawal, protracted withdrawal, and post-acute withdrawal syndrome (PAWS).

Withdrawal refers to the symptoms that occur when someone dependent on a substance suddenly stops taking that substance. This process can be difficult and dangerous. Dependency is when the body adapts to the presence of a substance and becomes accustomed to its effects. When the drug is removed, the body attempts to readjust, causing a range of symptoms known as withdrawal.

Stages of Drug Withdrawal

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What Causes Drug Withdrawal?

When a person stops taking a drug after being reliant on it for a while, they experience drug withdrawal. Substance abuse causes changes in the brain and body. The sudden absence of the substance forces the body to readjust to functioning without it.
Withdrawal can occur with prescribed, non-abused medication, alcohol, and illicit drugs. Regardless of the substance, prolonged use can cause dependency and lead to withdrawal when use stops.

What Drugs Cause Withdrawal Symptoms?

Common drugs that can cause withdrawal symptoms include:
  • Alcohol
  • Benzodiazepines, barbiturates, and other central nervous system (CNS) depressants and sedatives
  • Marijuana
  • Heroin and prescription opioids
  • Cocaine, methamphetamine, and other stimulants like Adderall and Ritalin

Symptoms of Withdrawal

During the stages of drug withdrawal, symptoms can differ based on the substance, the duration and frequency of use, and the person’s health. Common symptoms of substance withdrawal include:
  • Trembling and tremors
  • Muscle pain or aches
  • Fatigue
  • Sweating
  • Depression
  • Anxiety
  • Nausea
  • Vomiting
  • Insomnia
  • Seizures
  • Dilated pupils

How Long Do Drug Withdrawal Symptoms Last?

The type of substance, the severity of the addiction, and the patient’s overall health are primary factors that affect how long withdrawal symptoms last. The acute and protracted stages of withdrawal, when most withdrawal symptoms occur, can typically persist for several weeks. Some individuals may continue to experience symptoms for months or years after their last use of the drug.

Factors That May Affect the Withdrawal Timeline

The following are key factors that can affect the timeline of drug withdrawal:
  • The type of substance
  • Duration of use
  • Quantity of use
  • Other drugs or medications being taken
  • Individual characteristics, including a person’s mental and physical health

Stages of Drug Withdrawal

Being aware of and understanding the stages of drug withdrawal is essential for effective detoxification and addiction treatment. The following are the primary stages:

Stage 1: Making the Decision to Quit

The first step in addiction treatment is acknowledging the problem and deciding to quit. The willingness to seek help is a significant hurdle to overcome and a key part of a successful recovery. Following this decision is finding the right facility and getting professional drug addiction treatment.

Stage 2: Withdrawal Symptoms Begin

This stage of drug withdrawal can begin within a few hours to a few days after the last drug use. Depending on the extent of the person’s addiction and the substance, the timeline the symptoms begin will vary. Benzodiazepine withdrawal symptoms, for instance, usually begin two to ten days after the last use. During this stage, the person may experience anxiety, agitation, irritability, and sleep disturbances.1

Stage 3: Symptoms Increase in Intensity

The third stage is known as acute withdrawal, and it typically begins within a few days to a week after the last drug use. During this stage, the person may experience more intense and severe symptoms, such as tremors, hallucinations, and seizures. Around 25% of people who withdraw from alcohol use disorder experience hallucinations twelve to twenty-four hours after their last drink.2

Stage 4: Symptoms Peak and Then Decline in Intensity

Of all stages, stage four is the period when symptoms peak and are most severe. This stage is known as protracted withdrawal, and it can last for several weeks to several months. After the symptoms peak, the person may continue to experience symptoms like depression, fatigue, and cravings for the drug.

When withdrawal symptoms begin showing a decline, this indicates that the detox process is about to end. Most rehab facilities administer medication at this stage to relieve the individual from severe symptoms.

Stage 5: Drug Withdrawal Can Appear Again in the Form of PAWS

The final stage is known as post-acute withdrawal syndrome (PAWS), and it can last for several months to years. During this stage, the person may experience lingering symptoms such as mood swings, difficulty concentrating, and sleep disturbances.

For example, several studies indicated that sleep disturbances can still occur one to three years after alcohol addiction treatment. PAWS may appear weeks or months into recovery and typically includes some symptoms experienced during the earlier stages and strong cravings.3

Is Drug Withdrawal Dangerous?

Withdrawal from some drugs, such as alcohol and benzodiazepines, can be potentially dangerous because of the severe physical symptoms that can occur. These symptoms can include seizures, hallucinations, and delirium tremens, which can be life-threatening. Thus, it is important for people who are physically dependent on drugs to undergo the stages of drug withdrawal under medical supervision in a controlled and safe environment.

How to Detox From Drugs Safely

The safest approach to detox from drugs is to seek medical assistance and adhere to the doctor’s recommendations. For those who are physically dependent on a drug and want to stop using it, it is important to detox from the substance in a safe and controlled manner.

A general practitioner will develop a customized detoxing plan and provide medications and support to help the patient through the stages. The treatment team may monitor the individual for potential complications and provide treatment as needed. Detoxing from drugs can be a difficult and potentially dangerous process. As a result, medical supervision is crucial to ensure safety and maximize chances of success.

What Are the Medications Used in Drug Detox?

Physicians can use several drugs to help manage the stages of drug withdrawal symptoms and make the detox process safer and more comfortable. The medications utilized during drug detox will vary depending on the drug abused and the individual needs of the person undergoing detox. Common medications used in drug detox include:4

Clonidine

Clonidine is an alpha-2 agonist. It works by activating the alpha-2 receptors in the brain. This can help to reduce anxiety and agitation and prevent seizures. Clonidine is typically used in combination with other medications and therapies to support the withdrawal process. It is also commonly used to treat high blood pressure.

Lofexidine

Doctors prescribe lofexidine to treat symptoms of opioid withdrawal. It works by decreasing the activity of the sympathetic nervous system. This can help to reduce some of the symptoms, such as anxiety, sweating, and rapid heartbeat.

Buprenorphine

Buprenorphine is a partial opioid agonist. It activates the opioid receptors in the brain to a lesser extent than full opioid agonists like methadone. Buprenorphine can help to reduce cravings and symptoms throughout the stages of withdrawal without causing the same level of intoxication as other opioids.

Methadone

Methadone is a medication commonly used to manage opioid withdrawal symptoms and cravings. Methadone is a full opioid agonist. It activates the opioid receptors in the brain to the same extent as other opioids, such as heroin or prescription painkillers. This can help to reduce cravings and withdrawal symptoms, but it can also cause intoxication and can be addictive.
Stages of Drug Withdrawal

How to Cope With Drug Withdrawal

There are several ways to cope with drug withdrawal, and it may take some time to find the best strategies. General tips for coping with the stages of drug withdrawal include:
  • Asking for help
  • Eating well
  • Exercising
  • Drinking plenty of water
  • Relieving symptoms with over-the-counter (OTC) medications
  • Sleeping

Continue Learning About Drug Withdrawal at Profound Treatment

Learning about the stages of withdrawal is essential for any individual undergoing detox or supporting a loved one. At Profound Treatment, we provide resources and support to help people better understand and manage withdrawal. We aim to ensure all stages are as safe and comfortable as possible by focusing on each patient’s needs and individual symptoms.

To assist individuals in the withdrawal and recovery process, we offer individual therapy, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), holistic therapies, such as art and animal therapy, and support groups. Contact Profound Treatment today for more information on drug withdrawal and to access our resources and support services.

Resources

  1. 1https://www.ncbi.nlm.nih.gov/books/NBK459239/
  2. 2https://hospitalhandbook.ucsf.edu/content/03-alcohol-withdrawal
  3. 3https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf
  4. 4https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014033/
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