Drug withdrawal

Drug withdrawal, colloquially referred to as abstinence syndrome, is a complex set of symptoms that develop when an individual ceases the use of drugs. This condition is life-threatening, and if we exclude cases of overdose, fatalities more often occur when individuals are forced to quit using the substance. Breakdowns can be accompanied by a high risk of heart attacks or strokes, and even respiratory failure.

Certain drug substances can lead to addiction from the very first episodes of use. The withdrawal from these drugs also results in distressing symptoms that compel individuals to resume their intake. This establishes a vicious cycle that becomes increasingly difficult to break. If you suspect that a loved one is suffering from drug addiction, seek help from a specialist immediately without waiting for withdrawal symptoms to appear. The physicians at IsraRehab clinic are open to answer your questions and provide the necessary assistance. 

What is drug withdrawal?

The abstinence syndrome is characteristic of any form of chemical dependency. It is a complex set of physiological, psychoneurological, and somatic symptoms that develop as a result of discontinuing the habitual dose of a drug substance. It does not matter whether this discontinuation is due to an individual’s willpower or the inability to use the substance.

The symptoms can vary depending on the specific substance, the individual’s baseline health, and the duration of use. The most severe manifestations of withdrawal typically occur in cases of heroin, crack cocaine, methadone, methamphetamine, benzodiazepines, “bath salts,” and other potent narcotics.

The mechanisms behind withdrawal are determined by the type of drug. However, in all cases, physical dependence on the substance occurs, with it becoming part of the body’s biochemical processes. It interferes with neurotransmitter functioning, vascular tone regulation, and other vital processes. The absence of the usual substance triggers painful and distressing reactions. The body essentially tries to, by its own means, recreate conditions that correspond to intoxication by the familiar substance in order to function normally. Therefore, breakdown symptoms are a consequence of the body’s attempts to compensate for the absence of the substance, and they will inevitably manifest in any form of addiction.

Signs of drug withdrawal 

Withdrawal symptoms, or abstinence syndrome, can vary among individuals. On average, the initial symptoms start to appear within 8-12 or 24-48 hours. These symptoms can be categorized into two groups:

  • Psychopathological symptoms.
  • Vegetative and somatic neurological symptoms.

The severity of each symptom can vary depending on the type of addiction. For example, with barbiturate addiction, psychopathological symptoms are more pronounced, while with heroin use, vegetative symptoms tend to be more prominent.

Withdrawal takes place in phases, meaning not all symptoms manifest simultaneously. Among the most common symptoms are:

  • Irritability, aggressiveness, and anger;
  • Chills, fever;
  • Stuffy or runny nose;
  • Increased sweating;
  • Excessive salivation;
  • Nausea and vomiting;
  • Pain in muscles, joints, and throughout the body;
  • Loss of appetite;
  • Swelling in the extremities, etc. 

The symptoms tend to intensify and the peak falls around 3-4 days after discontinuation. Individuals may experience elevated blood pressure, headaches, tachycardia, diarrhea, abdominal pain, muscle cramps, etc.

One of the most excruciating symptoms is almost always severe body pain. This pain is due to disrupted transmission of nerve impulses, causing the brain to receive false signals that something is wrong. As a result, the subjective perception of pain is very severe even though there are no physical injuries to the muscles and joints.

It’s the withdrawal that pushes addicted ones to seek out drugs again – they simply cannot endure these withdrawal symptoms for an extended period.  

Heroin withdrawal

Heroin withdrawal is one of the most severe syndromes and can last up to three weeks. Heroin is an opiate, and dependence on it forms relatively quickly. More often than not, injection use is prevalent, and it’s not uncommon for severe viral infections to occur, complicating the course of withdrawal.

The withdrawal syndrome can develop as soon as 9 hours after the last instance of use. Initially, there is restlessness and irritability, along with a sense of fear. After some time, symptoms such as chills, sneezing, profuse nasal and ocular secretions, and increased sweating emerge. The overall condition may resemble a respiratory illness but in a severe form.

Subsequently, additional symptoms set in, including excessive salivation, nausea, vomiting, diarrhea, and seizures.

If the person hasn’t resumed drug use, they may experience weight loss. The concluding symptom is the development of severe pain and itching. The pain can be so excruciating that it can drive a person to madness. On the fifth day, symptoms may start to diminish, with a reversal of their appearance – the last symptoms to appear are the first to disappear. 

Crack cocaine withdrawal

Crack cocaine, produced from unrefined cocaine and soda or any other chemical base instead of the latter, is a drug that is usually smoked. Although other methods of consumption are also known. Dependency on crack develops more rapidly than with purified cocaine, and withdrawal is more severe.

The euphoria from crack cocaine lasts only 5-10 minutes, forcing dependent individuals to consume the substance frequently, often increasing the dose.

Immediately after the euphoria, a depressive state sets in due to a drop in dopamine levels. Suppression and irritability can drive individuals to use the drug again and again, often leading to sleep deprivation. Such dependents experience poor sleep and rapid weight loss. Once the dependent wants to quit the use, withdrawal occurs. In fact, withdrawal begins just 10 minutes after the last instance of use but worsens with additional symptoms later on, including:

  • Tachycardia;
  • Muscle spasms;
  • Paranoid tendencies;
  • Breathing problems;
  • Psychosis;
  • Tremors;
  • Hallucinations of various kinds, etc.

This type of breakdown can be accompanied by a condition called delusional parasitosis. It is when individuals experience hallucinations of insects crawling under their skin. Crack cocaine withdrawal can last up to two weeks, similar to cocaine withdrawal. 

Methadone withdrawal

The severity of methadone withdrawal can be compared to heroin withdrawal but it lasts longer, up to four weeks. Those who have experienced both explain that while it’s possible to endure heroin withdrawal, it’s impossible to endure methadone withdrawal due to the excruciating physical suffering. Common symptoms of methadone withdrawal include:

  • Tremors in the hands and legs;
  • Severe pain in the lower extremities;
  • Increased sensitivity to pain;
  • Visual and auditory hallucinations;
  • Suicidal tendencies;
  • Severe depression. 

Dependents may go without sleep for several days, experience panic attacks, and intense pain.

Methamphetamine withdrawal

Methamphetamine is a psychostimulant, a derivative of amphetamine. There are several methods of use, including orally, intravenously, or intranasally. The substance has an effect that lasts up to 12 hours, and withdrawal starts as early as 7-8 hours after the last use. Depending on the individual’s health and duration of use, withdrawal can last up to 12 weeks, with the first week being the most challenging.

If there is only a psychological dependency, withdrawal symptoms affect only the psycho-emotional sphere, resulting in:

  • Dysphoria: a sense of unease, gloomy, lowered mood;
  • Nervousness;
  • Depression.

In cases of physical dependence, severe psychomotor agitation, eye itching, muscle pain, and uncontrolled appetite attacks develop. This phase can alternate with apathy, detachment, and an escape from reality.

The person suffers from sleep disturbances: sleeping more than usual or experiencing insomnia. Hallucinations, paranoid schizophrenia, fear, and uncontrollable anxiety can lead individuals to attempt suicide. 

This type of withdrawal is complicated by high risks of severe health complications, potentially leading to a coma.

Cocaine withdrawal

Cocaine breakdown lasts up to two weeks, but its consequences for mental health can persist for a longer period. Overall, the withdrawal picture resembles that of crack cocaine withdrawal syndrome. Paranoid disorders, suicidal thoughts, consciousness confusion, fever, and severe sleep disturbances can occur. 

Amphetamine withdrawal

The initial withdrawal symptoms occur 6-8 hours after the last use and can persist from a few weeks to 6 months. In addition to the typical manifestations seen in all types of withdrawal, the following are characteristic:

  • Swelling of the hands and feet;
  • Nightmares;
  • Panic attacks;
  • Irritability, emotional instability;
  • Fatigue, complete exhaustion;
  • Tremor;
  • Coordination disturbances;
  • Auditory, visual, and tactile hallucinations;
  • Severe headaches;
  • Depression. 

Benzodiazepine withdrawal

Benzodiazepines are psychoactive substances with sedative, hypnotic, anticonvulsant, and muscle relaxant effects. They may also be taken under medical prescription.

Physical dependence on these substances leads to withdrawal symptoms that can persist for years. Withdrawal is accompanied by the following manifestations:

  • Tension and anxiety;
  • Panic attacks;
  • Hand tremors;
  • Increased sweating;
  • Concentration disturbances;
  • Confusion;
  • Cognitive impairments;
  • Nausea and vomiting;
  • Weight loss;
  • Tachycardia;
  • Headaches;
  • Muscle pain;
  • Hallucinations;
  • Seizures;
  • Psychosis;
  • Thoughts of suicide.

These symptoms may not all occur simultaneously. Furthermore, they may intensify and weaken intermittently, rather than diminishing over time as in other cases. 

Gamma-hydroxybutyrate (GHB) withdrawal

Gamma-hydroxybutyrate is a synthetic substance with effects similar to the neurotransmitter GABA. It causes intoxication comparable to ketamine or ethanol, depressing the nervous system. 

This substance is used as an alternative to amphetamines and even as a quick way for athletes to gain weight. Its effects are relatively short-lasting, up to 3 hours. Withdrawal symptoms are comparable to alcohol withdrawal or benzodiazepine withdrawal and can pose high risks to a person’s life. 

MDPV (Methylenedioxypyrovalerone) withdrawal

Methylenedioxypyrovalerone, or MDPV, is a psychoactive substance with effects resembling those of cocaine and amphetamines. Its use is associated with rapid addiction. The withdrawal syndrome resembles the manifestations of withdrawal from methamphetamine use. Symptoms can also include spasms of the jaw muscles, a condition called bruxism, and pain in the abdominal and kidney areas. 

“Spice” withdrawal

This is a group of drug substances produced from mixtures of herbs and synthetic cannabinoids. The individual becomes addicted in a very short time, and even a single use can cause enormous harm to health. 

Smoking blends lead to severe disruptions in memory, attention, and intellectual functions. Since the composition of these drugs can vary depending on the manufacturer, even experienced physicians may not always recognize what a person has consumed.

Withdrawal symptoms can manifest in various ways. In most cases, doctors deal with the following set of symptoms:

  • Uncontrollable fear;
  • Outbursts of aggression and panic;
  • Antisocial behavior;
  • Disorientation in time and space;
  • Schizophrenia-like states. 

Dealing with drug withdrawal

Dealing with drug withdrawal on your own is extremely challenging. Additionally, such a condition poses a direct threat to your health and even your life. It is crucial to seek medical assistance within the shortest possible time, especially in cases of prolonged drug use.

The likelihood of acute cerebrovascular disorders, myocardial infarction, organ failure, and severe respiratory disturbances is very high. The development of psychosis and depression can lead to suicidal tendencies.

The management of withdrawal symptoms should be entrusted to a medical professional, where the treatment process occurs within the confines of a medical institution. It’s important not to leave the patient unattended and monitor vital parameters such as blood pressure, heart rate, and oxygen saturation.

Detoxification therapy involves not only removing toxins from the body but also using symptomatic drugs to alleviate distressing symptoms. This approach not only reduces the duration of withdrawal but also improves the patient’s well-being. Various types of medications may be used, including:

  • Cerebroprotective agents;
  • Pain relievers;
  • Anticonvulsants;
  • Sedatives;
  • Antidepressants;
  • Antipsychotics;
  • Mood stabilizers, etc. 

Subsequent health recovery involves the use of vitamin and mineral complexes, hepatoprotective agents, and other treatments.

As the patient’s condition improves, comprehensive psychosocial rehabilitation can be initiated. Working with a psychotherapist and utilizing effective tools and programs is essential for addressing the root causes of addiction and preventing relapse in the future.

The IsraRehab clinic annually helps dozens of individuals with rehabilitation. They employ effective approaches and treatment tools for addiction, such as the 12-step program and various methods of psychotherapeutic interventions, counseling, and group training.

The remote location of the clinic from the city is a mandatory condition for preventing relapse. Isolation from the previous environment allows individuals to maintain sobriety until stable results are achieved through work with psychotherapists. The program includes sightseeing trips, walks, including through their fruit orchards. They organize trips to the sea and the swimming pool, offer sports activities, and games like table tennis and billiards.

Comfortable rooms with all the necessary amenities are provided to patients: each room is equipped with a bathroom, shower, TV, and other conveniences.

Going through withdrawal alone is not only difficult but also highly dangerous. Entrust yourself to professionals: reach out to IsraRehab and get answers to all your questions.

The article was verified by a practical psychologist

Psychology teacher,
art therapist

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