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Withdrawal Guide

Humanity has existed for centuries, but in 2019, the United States has reached an all-time high from suicide, alcohol, and drug overdoses. When you look at the current state of affairs in states like Ohio, West Virginia, and Pennsylvania, it’s no wonder that these numbers have reached epidemic levels. West Virginia had the highest number of drug overdose death rates, which have been fueled largely in part due to the opioid crisis. The numbers have shot up 450 percent from 2005 to 2017 according to some reports.

There are many reasons why individuals will choose not to get sober, but one primary reason is the fear of withdrawal. It can be a long process that tests human will and strength as drugs or alcohol exit the body. Drugs affect how our body functions, and when someone uses drugs or alcohol, they change their brain and bodily systems. Some of these changes are mild, but others can be more severe and life-threatening. Some drugs will change how our body functions, and in turn, cause our body to rely on the substances to function normally. 

When you take the huge step to quit using these substances and change your life, people can fall ill and suffer from withdrawals, which is a common occurrence in the rehab process. It is incredibly difficult to get through this process alone for some, and many will seek professional help to ensure they can get through it unscathed.

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What we must keep in mind is that every drug is going to produce different effects. Some may produce withdrawals that are much more physical, while other drugs will cause much more emotional types of withdrawals. Every person’s physical pattern is going to differ, and this will change the path for two people who may be using the same drug. They may experience little physical withdrawal, but that should not indicate you are not addicted, because you may end up with a more emotional withdrawal.

Cutting a routine from your daily schedule means you need to make adjustments in your everyday life. The condition will strike an individual who uses drugs regularly and stops. When someone breaks that routine, the brain is going to react with surges of adrenaline, which is going to cause cravings along with other symptoms. Let’s take a look at how to identify withdrawal symptoms and what causes drug addiction.

Causes and Symptoms of Drug Dependence

Many people who use drugs and alcohol will develop a drug dependence, and that means their bodies will be unable to function normally without its presence. The National Institute of Health (NIH) highlights the most common factors that lead to drug dependence and addiction. 

These are:

  • Depression
  • Anxiety
  • Peer pressure
  • Low self-esteem
  • Emotional or environmental distress
  • Post-traumatic stress disorder (PTSD)
  • Attention deficit disorder (ADD)
  • Attention deficit hyperactivity disorder (ADHD)

The National Institute of Health also mentions the symptoms of drug dependence, which include:

  • No control of their drug use
  • Using drugs alone to cope with life
  • Using drugs daily to function normally
  • Avoiding work or school obligations
  • Poor performance in their work or school obligations
  • Violence or hostility relating to their drug use
  • Continuing to use drugs despite psychological, physical, or social damage

How to Identify Withdrawal Symptoms

As we mentioned above, different drugs or alcohol are going to produce different effects. Alcohol and opioids have become the most popular, and they cause significant withdrawal symptoms, such as nausea, sweating, and thoughts of suicide. In some cases, alcohol withdrawal can be fatal. Other substances, however, like marijuana or cocaine are going to cause emotional symptoms such as irritability and depression.

The manifestation of symptoms can last a few days to a few months. The severity is going to range from mild to chronic and life-threatening. It will be based on the person’s physical and psychological characteristics, age, how long they’ve used the drugs, their last dose, and how much they were using at a time. 

Types of Emotional Withdrawal Symptoms

  • Anxiety: Anxiety is a common part of life, but those going through withdrawal will experience symptoms that are much more intense. They could experience excessive worrying, feelings of agitation, restlessness, fatigue, difficulty concentrating, and tense muscles. Anxiety is a reason many start using drugs in the first place. Some drugs will cause rebound symptoms, which is when their symptoms return worse than they experienced before. They may have problems falling asleep, panic attacks, and irrational fears.
  • Depression: There is no real way to predict if you’re going to have symptoms of depression when you stop using drugs or alcohol, but in the event you do, it’s best to be around a team of medical professionals. Depression can cause thoughts of suicide, and even if you are detoxing from marijuana, this can be fatal if left untreated. Other symptoms may include a loss of interest in daily activities, appetite or weight changes, anger, loss of energy, self-loathing, feeling helpless, and reckless behavior.
  • Sleep: An inability to sleep is among the worst issues you can experience. You may want to go to sleep to avoid the severity of the symptoms, but you will be unable to because your body is rebounding and trying to return to normal. In medical detox, they will be able to provide medications that help you sleep.
  • Cognitive: When you are feeling at your worst, it’s not all too surprising that you’ll have some cognitive issues. Some of these may include a difficulty to sit still, unable to access your short-term memory, lack of focus, inability to make decisions, or frequently losing things and forgetting where they are. When added to a lack of sleep, anxiety, and depression, you can understand why it’s safer to be in a detox facility.

Dangerous Withdrawal Symptoms

Alcohol and tranquilizer drugs are going to cause the most physical withdrawal symptoms. When you abruptly stop using these drugs, it can cause an increased risk of a heart attack in some individuals. A medically supervised detox will mitigate these risks and alleviate withdrawal symptoms with the use of specific medications. 

Other dangerous withdrawal symptoms you can experience may include:

Post-Acute Withdrawal Syndrome

According to the Semel Institute for Neuroscience and Human Behavior, post-acute withdrawal syndrome (PAWS) refers to a set of impairments that can persist for weeks or months after abstaining from a substance of abuse. The condition can cause anxiety, mood disorders, insomnia, and increased levels of anxiety without any apparent stimulus.

PAWS is most likely to occur after a withdrawal period from benzodiazepines, alcohol, and opioids. While less likely, it can occur with the use of other psychoactive substances. A staggering 90 percent of those in recovery from opioid abuse will experience the symptoms to some extent. In addition to opioids, 75 percent of psychotropic and alcohol users will experience the effects as well. Scientists believe this occurs due to the physical changes drugs make on the brain.

Signs and symptoms of PAWS may include:

  • Irritability
  • Anxiety
  • Panic
  • Depression

Other symptoms may include:

  • Difficulty maintaining social relationships
  • Disturbances in sleep patterns months after stopping drug use
  • Very sensitive to stress
  • Apathetic
  • Pessimistic
  • Cravings for substances weeks, months, or even years after abstaining
  • Obsessive-compulsive behaviors

Alcohol Withdrawal Symptoms

The problem with alcohol abuse is that it can begin innocently.

Many of us experiment in college, and from that point forward, we may have a cocktail or two at a social gathering.

For some, however, that one or two can turn to four or five, and the drinking may continue once the event ends. Many of us are unaware that a genetic makes us more prone to addiction.

How often someone drinks is going to contribute to the severity of their symptoms, and once they are hooked, it will be hard to stop.

Those who drink heavily through the day and decide to quit are at risk of developing alarming symptoms. These can affect many areas of their lives.

Alcohol withdrawal symptoms can include:

  • Clammy skin
  • Anxiety
  • Dilated pupils
  • Fatigue
  • Insomnia
  • Mood swings
  • Seizures
  • Delirium Tremens (DTs)

These symptoms can appear in as little as eight hours after your last drink. Severe effects  like confusion, high fevers, and seizures can also occur and become fatal.

Co-occurring disorders can lead to a misdiagnosis, which will lead to a failure of treating delirium tremens. The most common co-occuring disorder is known as Wernicke-Korsakoff syndrome, which is a sometimes fatal brain disorder.

Cocaine Withdrawal Symptoms

Cocaine is an extremely addictive, stimulant drug. It is often used at parties and puts the user into a state of euphoria. When someone becomes addicted to the drug, it makes it extremely difficult to stop using the drug on your own. Cocaine withdrawal is not deadly in comparison to other drugs, but it can cause someone to be suicidal.

Other withdrawal symptoms include:

  • Fatigue
  • Memory loss
  • Insomnia
  • Nightmares
  • Increased in appetite
  • Social isolation
  • Seizures

Studies have highlighted a correlation between mental illness and cocaine addiction. These include attention-deficit disorder or depression. Suicidal thoughts are also common in cocaine users.

Opioid Withdrawal Symptoms

As we discussed earlier in the article, drug use has reached an all-time high. Much of this can be attributed to the rise in opioids.

Prescription drug use has risen dramatically since 2000, and the opioid crisis started with people abusing their pain medication.

Once restrictions were placed onto prescribing habits by doctors, drug users moved to using illicit opioids such as heroin. In the years following, fentanyl became an extremely popular drug of choice due to its low cost and strength.

While not deadly, opioids are among the most challenging drugs to become clean. Individuals who attempt to get sober on their own will more than likely fail. The severity of the withdrawals are enough to make someone give in to their cravings to make the pain stop. 

There are two stages of withdrawal, which are viewed as early and late symptoms. These include:

Early Symptoms

  • Sweating
  • Muscle aches
  • Anxiety
  • Watery eyes
  • Agitation

Late Symptoms

  • Nausea
  • Vomiting
  • Diarrhea
  • Dilated pupils
  • Abdominal cramping

Preparing for Withdrawal Symptoms

Someone that is working toward a sober life must be prepared for what is coming next. Withdrawal is something difficult to overcome, but being prepared mentally and preparing for what to expect will help you through this challenge. First and foremost, you must speak with a physician or addiction specialist to determine the best course of action. 

When you speak to them, it is time to decide what will work best for you. You must write down the pros and cons of giving up your drug or alcohol of choice, as this can sustain motivation when it gets tough.

 Reverting to old habits is a possibility during withdrawal, and during a rough patch, you may slip up or relapse completely. It’s essential for you to understand the process, what worked well, and how you can improve on that in the future.

If you plan to forego this arduous process alone, there are ways to make it slightly more tolerable. While junk food may sound alluring, you must stick to a healthy diet of fruits and vegetables. These can reduce the number of symptoms, which include mood swings. Nutrition is crucial during recovery, especially for people who have neglected their health during long periods of drug or alcohol use. You must also stay hydrated by drinking one to two liters of water every day.

You must find ways to stay busy during withdrawal to help you from thinking about the pending process. If you can do so, look into reading, exercising, or doing yoga to help cope with what is to come.

Medical Detoxification & Medications

A detox center will provide medications that ease withdrawal symptoms and keep you safe. Those who avoid treatment will not have access to these resources, and this can lead to fatal consequences. During alcohol withdrawal, clinicians may administer Valium and Ativan. The severity of withdrawals will determine the dose, and the client will then be tapered off these medications.

Several medications may be available during opioid withdrawal, which includes buprenorphine, methadone, or naltrexone. It will ease cravings, and clonidine will reduce discomfort. In some cases, Librium will be used to decrease agitation, while trazodone will help the client sleep.

Administering medicine will benefit the client and keep them comfortable. In addition to medications, the treatment center staff will check electrolyte levels, blood chemistry, and body fluid levels. Withdrawal can be unpredictable, and knowledgeable staff members aim to keep you safe. Their primary goal is to ensure your safety and comfort. If you have been abusing drugs or alcohol and are ready for a change, you must speak to your physician to determine what is next for your life.

Sources

Herman, J. B., Brotman, A. W., & Rosenbaum, J. F. (1987, October). Rebound anxiety in panic disorder patients treated with shorter-acting benzodiazepines. from https://www.ncbi.nlm.nih.gov/pubmed/2889722

(2019, March 5). Depression. from https://medlineplus.gov/depression.html

(2019, June 18). Grand mal seizure. from https://www.mayoclinic.org/diseases-conditions/grand-mal-seizure/symptoms-causes/syc-20363458

(n.d.). Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/000949.htm

Edwards, E. (2019, June 12). U.S. death rates from suicides, alcohol and drug overdoses reach all-time high. from https://www.nbcnews.com/health/health-news/u-s-death-rates-suicides-alcohol-drug-overdoses-reach-all-n1016216

(n.d.). Substance use disorder: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/001522.htm

Rahman, A. (2018, November 18). Delirium Tremens (DT). from https://www.ncbi.nlm.nih.gov/books/NBK482134/

(n.d.). Post-Acute Withdrawal Syndrome (PAWS). from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS

(n.d.). Wernicke-Korsakoff syndrome: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/000771.htm

Smith, M. J., Thirthalli, J., Abdallah, A. B., Murray, R. M., & Cottler, L. B. (2009). Prevalence of psychotic symptoms in substance users: a comparison across substances. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743957/

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