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Drug and Alcohol Withdrawal

(Abstinence Syndrome)

Definition

Withdrawal is a reaction that happens after drugs or alcohol are stopped.

Withdrawal can be very serious and lead to death.

Causes

Constant misuse changes how your body works. Once you stop, your body needs a chance to get back to normal. During this time, your body can't work as it should. This leads to withdrawal. It can be severe when the stop is sudden.

Risk Factors

Your chances of withdrawal are higher for:

Sudden stopping of certain medicines, drugs, or alcohol
Having problems with any kind of substance use disorder

Symptoms

Withdrawal will start after use is stopped. This can be with a few hours to a few days. The types of problems depend on the substances and the length of misuse. The most common are:

Anxiety
Agitation
Tremors or shaking
Fast heartbeat— tachycardia
Problems thinking or understanding
Changes in hunger patterns
Sweating
Fever
Feeling weak
Nausea or vomiting
Sleeping problems
Seizures
Drug craving
Hallucinations—seeing or hearing things that aren't there

Anxiety

Anxiety is a symptom of drug withdrawal from substances like cocaine and alcohol.

Diagnosis

You will be asked about your symptoms and health history. You may have:

A physical exam
Blood tests
Urine tests

Treatment

Detox with help from healthcare is safer than doing it on your own. Having care will help with:

Watching and helping with problems such as:
- Seizures
- Changes in your mental state
- Delirium tremens
Supportive care to ease symptoms

How you're treated depends on what you need such as:

Vitamins and nutrients
Fluids—for dehydration
A quiet, healthy place to get better
An electro auricular device—gives small electrical pulses to ear to help control opioid withdrawal symptoms

Medicines are used to:

Ease cravings and other withdrawal symptoms
Control depression, anxiety, and balance your mood
Prevent seizures

Opioid and benzodiazepine withdrawal may be helped with:

Exercise
Good sleep habits

Rehabilitation

Detox is the first step in getting help. Later steps involve therapy or group therapy . They can help you stay away from harmful habits.

Prevention

You can't prevent withdrawal once drug or alcohol misuse has started.

RESOURCES

National Institute on Drug Abuse
https://www.drugabuse.gov

Substance Abuse and Mental Health Services Administration
https://www.samhsa.gov

CANADIAN RESOURCES

Canadian Centre on Substance Use and Addiction
http://www.ccsa.ca

Toronto Area of Narcotics Anonymous
http://www.torontona.org

References

Alcohol withdrawal syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114807/Alcohol-withdrawal-syndrome . Updated January 17, 2017. Accessed August 21, 2018.

Benzodiazepine withdrawal syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114807/Alcohol-withdrawal-syndrome . Updated July 18, 2018. Accessed August 21, 2018.

Cannabis use. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T912430/Cannabis-use . Updated April 27, 2018. Accessed August 21, 2018.

Cocaine toxicity—emergency management. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T910330/Cocaine-toxicity-emergency-management . Accessed August 21, 2018.

Drugs, brains, and behavior: The science of addiction National Institute for Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface. Updated July 2018. Accessed August 21, 2018.

Opioid abuse and dependence. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T219069/Opioid-abuse-and-dependence . Updated June 14, 2018. Accessed August 21, 2018.

Opioid withdrawal. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115893/Opioid-withdrawal . Updated November 17, 2018. Accessed August 21, 2018.

Principles of drug addiction treatment: a research based guide. National Institute of Drug Abuse website. Available at: http://www.drugabuse.gov/publications/principles-drug-addiction-treatment. Updated December 2012. Accessed August 21, 2018.

Sedative-hypnotic overdose. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114858/Sedative-hypnotic-overdose . Updated July 21, 2017. Accessed August 21, 2018.

Treatment approaches for drug addiction. National Institute for Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction. Updated January 2018. Accessed August 21, 2018.

Revision Information

Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
Review Date: 05/2018
Update Date: 08/21/2018

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.