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What Happens During Withdrawal?

By 
Hannah Friedman
|
 February 5th, 2022|   Clinically Reviewed by 
Rajnandini Rathod

When you enter addiction recovery, you may or may not go through withdrawal—and you can’t always predict whether you’ll have symptoms. If you’re ready to quit drugs or alcohol, it’s a good idea to make a safety plan. And depending on your specific addiction, that plan might need to include medical detox.

What Causes Withdrawal?

Quitting any addiction can cause withdrawal.1 That’s true for drugs, alcohol, and even behavioral addictions like gambling. But your exact experience depends on your mental and physical health. Withdrawal doesn’t affect everyone2 in recovery. That’s because there are different ways you can come to rely on a substance.

Dependence

When you’re physically dependent on a drug, your body’s used to ingesting it on a regular basis. And you’ll probably experience physical effects when you stop taking it. This is what most people think of when they picture withdrawal.

But you can be dependent on non-addictive drugs,3 too. If you stop taking your asthma medication, you’ll probably feel immediate effects. The same is true for mental health meds, like antidepressants. Dependence doesn’t equal addiction. It’s a physical experience. But the 2 often go hand in hand.

Addiction

Many addictions include physical dependence—but not all of them. Video game addiction, for example, is behavioral. Some experts even call drug addiction a mental health issue,4 rather than a physical one.

People with untreated addiction keep engaging in unhealthy behavior1 in spite of its adverse effects. Those effects could be physical, mental, social, or even spiritual. And for some people, quitting causes physical symptoms—even if you weren’t physically dependent on a drug.

What Are the Most Common Symptoms?

Everyone’s recovery journey is a little different. But these are a few of the most common withdrawal symptoms:

  • changes in appetite
  • nausea
  • diarrhea
  • vomiting
  • sleep disturbances, like insomnia or excessive tiredness
  • mood changes or mood swings
  • tremors
  • anxiety
  • depression

These symptoms might be more or less severe depending on your overall health. If you have any chronic conditions, make sure to ask your doctor how to manage them while you’re going through this transition. Whether or not you get formal treatment during, it’s important to make a plan for support during detox and withdrawal.

Can You Die From Withdrawal?

In short: yes, you can die from withdrawal. Certain addictions are strongly associated with physical dependence. And when you quit these drugs, you might have very serious symptoms. Talk to your doctor about medical detox if you’re quitting off any of the following:

Without proper care, withdrawal from these 3 substances can be life-threatening. And even if your physical symptoms are minimal, detoxing off any drug can reveal other health concerns.

How Long Does Withdrawal Last?

It depends on what drugs you’ve been taking, and in what quantities. And your other health issues can play a role here. For example, nicotine is an antipsychotic.5 So if you have schizophrenia and you smoke cigarettes, they can interact with your prescribed meds. For people with co-occurring disorders, withdrawal and detox are often complex.

If addiction is your only concern, it may be easier to estimate how long you’ll spend in withdrawal. The Substance Abuse and Mental Health Services Administration (SAMHSA), estimates the following withdrawal timelines6 for various substances:

  • Alcohol withdrawal lasts 5-7 days.
  • Benzodiazepine withdrawal lasts 1-5 weeks.
  • Opioid withdrawal (except methadone) lasts 4-10 days.
  • Methadone withdrawal can last up to 3 weeks.
  • Stimulant withdrawal lasts 1-2 weeks.
  • Cannabis withdrawal lasts approximately 5 days.
  • Nicotine withdrawal lasts between 2-4 weeks.

These are just general guidelines—your symptoms may subside faster. And for some people, they go on much longer.

If you’re still feeling the effects of withdrawal long after these estimated timelines, talk to your care team about your options. At that point, you might need an evaluation for post-acute withdrawal syndrome (PAWS). This condition is serious, but treatable. And with your provider’s support, you can continue to move forward.

What Happens After Withdrawal?

Quitting is just one step in your journey. After you go through withdrawal, you’ll have several options. You might start therapy, or join a support group. If you attend medical detox, you might be required to go straight into residential rehab. Some facilities even combine these programs, so you won’t need to move in the middle of treatment. But there are countless ways to map out the recovery process. The important thing is choosing a path that meets your specific needs.

To start planning your recovery, learn about treatments, housing options, and insurance coverage at residential detox centers.

Reviewed by Rajnandini Rathod

  1. Alavi, Seyyed Salman, et al. “Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views.” International Journal of Preventive Medicine, vol. 3, no. 4, Apr. 2012, pp. 290–94. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/. [] []
  2. Saitz, Richard. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 5–12. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/. []
  3. Szalavitz, Maia, et al. “Drug Dependence Is Not Addiction—and It Matters.” Annals of Medicine, vol. 53, no. 1, pp. 1989–92. PubMed Central, https://doi.org/10.1080/07853890.2021.1995623. Accessed 27 Dec. 2022. []
  4. “Substance Use and Co-Occurring Mental Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health. Accessed 27 Dec. 2022. []
  5. Lyon, E. R. “A Review of the Effects of Nicotine on Schizophrenia and Antipsychotic Medications.” Psychiatric Services (Washington, D.C.), vol. 50, no. 10, Oct. 1999, pp. 1346–50. PubMed, https://doi.org/10.1176/ps.50.10.1346. []
  6. “Protracted Withdrawal.” Substance Abuse Treatment Advisory. July 2010 Volume 9 Issue 1. https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf []

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