What Is Withdrawal?

Medically reviewed by Melissa Bronstein, LICSW

Withdrawal is your body's response when you suddenly stop using a certain substance, such as alcohol, nicotine, marijuana, medications, or other drugs. Once you quit or reduce your use of a substance, you can experience a variety of symptoms that affect both your emotional and physical health. Symptoms may include anxiety, fatigue, sweating, trouble sleeping, and having cravings for the substance.

Getting sober offers several health benefits. But, going through withdrawal is often challenging—and it's OK if you find the process difficult. That's why it's important to lean on your support system during your treatment journey, which may include your family and friends, your healthcare team (like your primary care provider and a therapist), or a support group.

Types of Withdrawal

Several substances can lead to withdrawal symptoms. The symptoms of withdrawal you experience will often depend on the substance(s) you previously used. Most people experience withdrawal after long-term use of the following substances:

• Nicotine and tobacco products, such as cigarettes or e-cigarettes

• Alcohol, including wine, beer, or spirits

• Depressant medications, which can come in the form of sedatives and tranquilizers to help reduce anxiety and improve sleep problems

• Opioids, such as heroin and pain relievers like oxycodone, hydrocodone, and morphine

• Stimulant drugs, such as caffeine, cocaine, and methamphetamine

• Cannabis and marijuana

• Inhalants, like getting high off of spray paints or household cleaners
  

Symptoms

Your withdrawal symptoms will vary based on the substance(s) you previously used and how long you were using it. Depending on which type of withdrawal you're experiencing, you might have the following symptoms:

Causes

Continuous use of a substance can cause you to become physically and emotionally dependent on the drug. As a result, you might also need to use more of the same substance to get the same relief or effects of the drug you previously experienced before your addiction. How long it takes to become dependent on a substance varies on factors like your overall health and the substance you're using.

The primary cause of withdrawal is suddenly cutting back or quitting the use of a substance after a long period of time. Withdrawal symptoms can be very difficult to endure. That's because your body is adjusting to no longer being on a substance and trying to balance itself without being under the influence of the drug. As a result, your brain's chemistry might temporarily change during withdrawal, which causes you to experience physical and mental symptoms.

Diagnosis

Withdrawal symptoms can range from mild to severe and, in some cases, be life-threatening. If you're thinking about stopping or cutting back on a substance you've been using for a long time, it's good practice to talk to your healthcare provider about how to safely withdraw from the drug. They can help you plan for withdrawal, teach you about the withdrawal symptoms you might experience, offer medications to make the process easier, or give you resources for extra support.

There's no one specific test that providers use to diagnose withdrawal. However, if you're experiencing withdrawal symptoms, your healthcare provider will likely:

• Ask you about your medical history, the substances you've been using, and other lifestyle habits

• Inquire about the physical symptoms you have, how you're feeling emotionally, and your decision to stop using substances

• Perform a physical exam to check for common withdrawal symptoms such as a rapid heartbeat, shaky hands, and headaches

• Order blood or urine tests to check for toxins or substances that are still in your system and to evaluate your overall health

• Refer you to a mental health provider for support and further treatment, such as psychotherapy, to help you work through your healing journey with more ease
  

Treatment

Treatment for withdrawal primarily includes support from your loved ones and healthcare team, lifestyle changes, medications, and if necessary, a medical detox. Withdrawal can be extremely challenging to undergo. If you are considering becoming sober, talk to your provider about what treatments can help make this process easier for you. They may offer the following:

• Seeking support from your loved ones to hold you accountable after you stop using a substance

• Working with a mental health provider or trying therapy to help you reframe your thoughts about substance use and find healthier ways to cope

• Joining a support group for additional care during your healing journey

• Taking over-the-counter medications to reduce symptoms like anxiety, nausea, or difficulty sleeping

• Eating nutritious foods

• Spending time in nature

• Participating in some type of physical activity or exercise throughout the week

• Getting enough sleep

Abruptly withdrawing from a more serious drug, such as a depressant or opioid, can be life-threatening. That's why it's essential to talk to your provider before you stop using a substance you've used for a long time. In these cases, your provider may recommend you undergo a medical detox.

A medical detox program provides around-the-clock care from a licensed professional as you safely stop using a substance. They can monitor your vital signs, keep track of the symptoms you're experiencing, give you in-house support at a facility, ensure your safety, and offer any necessary medications to help you reduce severe symptoms.

Prevention

The most effective way to prevent withdrawal is by abstaining from any use of substances. However, this practice is often easier said than done. Several factors can increase your risk of using substances, such as chronic stress, grief, childhood trauma, life changes (like moving, getting a divorce, or losing a job), peer pressure, or having a family history of substance use. Having a social support system and knowing healthier coping mechanisms for stress can reduce your risk.

If you are reliant on a substance, you are not alone. Taking substances to ease major stressors or pain doesn't make you a failure—it just means that you may need a little more support to get on your treatment journey and successfully heal. Unfortunately, there's no surefire way to prevent withdrawal symptoms, because it's your body's natural response when you stop using a substance. However, the following tips can make your recovery just a bit easier:

• Be open with your loved ones about your experience and ask them for the support you need

• Work with your healthcare team to learn how to manage the physical and emotional symptoms of withdrawal

• Implement other coping techniques for stress, such as eating nutritious foods on time, walking or doing another physical activity, taking part in hobbies you enjoy (or starting a new one), and getting enough sleep

• Give yourself grace and be patient as you recover
  

A Quick Review

Withdrawal is a complex and often challenging process your body goes through once you stop using a substance. Your withdrawal symptoms can depend on factors like what substances you used and how long you used them. It's common to experience symptoms like anxiety, fatigue, headaches, and trouble sleeping as you go through withdrawal.

Your journey to sobriety can be mentally and physically grueling. If you're thinking about quitting a substance, it's important to work with your healthcare provider. They can help you make a plan to safely withdraw from a substance, give you treatments to ease withdrawal symptoms, and offer resources for extra support. Following your withdrawal plan, implementing lifestyle changes, and relying on your loved ones can make this experience a more effective path toward recovery.

Frequently Asked Questions

What is the difference between acute and protracted withdrawal?

Acute withdrawal is often just called "withdrawal," which happens immediately after you stop using a drug you've been taking. If you have protracted withdrawal, this means that your withdrawal symptoms last longer than the usual withdrawal period.

How long does it take to have withdrawal symptoms?

The time for withdrawal symptoms to develop will vary based on the substance you've been using. For example, alcohol withdrawal symptoms start within eight hours, cannabis withdrawal symptoms begin 24 to 48 hours after the last use, and opiate withdrawal symptoms can occur anytime after your last use.

What type of withdrawal is the worst?

Some of the toughest drugs to quit include heroin, prescription painkillers, cocaine, meth, nicotine, and alcohol. Stopping suddenly can lead to severe physical and mental withdrawal symptoms, which can sometimes be life-threatening. Before you quit a substance, consult with your provider on how to safely withdraw.

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