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How Long Does a Withdrawal Last?

“If you can quit for a day, you can quit for a lifetime.”

Benjamin Alire Saenz

What’s the difference between detox and withdrawal?

A medical detox and withdrawal aren’t the same, although such phrases are often used interchangeably. For example, a medical detox involves prescribed medication to ease the symptoms during the withdrawal phase. A detox will wean the individual off prescribed medication until the symptoms associated with the withdrawal have passed. It’s an extremely sensitive process, which requires the expertise of experienced health professionals to monitor the process, tailoring medication to ease the symptoms of withdrawal.

A medically supervised detox involves a gradual elimination of chemicals with addictive properties (for example, opioids) or powerful substances such as alcohol from the body. The length of a detox varies depending on the individual’s size,physical condition, and levels of dependency. Some individuals will experience withdrawal symptoms from alcohol for two to three weeks, some longer, however for others it may be for a relatively short period of time (three to four days). Opioid addiction presents other challenges, and a withdrawal can last up to two weeks (however, prolonged withdrawal can occur too). This is why at Addcounsel, we have a ‘one client at a time’ methodology. We recognise how significant genetics, nutrition and lifestyle are in both the development of an addiction, and in the process of recovery, particularly during a detox. 

When an individual has become dependent on a powerful mood-altering substance, this will certainly have physical, psychological, and emotional implications. Every experience a person has literally rewires the human brain, therefore introducing a constant flow of strong mood-altering substances will interfere with wiring/pathways and connections in the brain. If this is left untreated over a significant period, cognitive impairment and brain damage can result.

Once the human brain has entered the dependency phase of addiction, it can be problematic and, in some cases, dangerous to detoxify without professional help or the integration of a long-term recovery programme. Alcoholism and drug addiction is a chronic brain disorder, and so a medical detox needs to be undertaken with the utmost care and competence. A withdrawal can be very uncomfortable and often distressing for the individual, even when supported by a team of health professionals.

So, to summarise, a withdrawal will happen when an alcohol/drug dependent person discontinues using alcohol/powerful drugs/painkillers, even without a medical professional supervising a detox. A detox is specifically tailored for and adapted to an individual’s needs by a health professional such as a psychiatrist/medical doctor and supported by a nurse and trained addiction professional.

Alcohol withdrawal

An individual going through an alcohol withdrawal without professional help may have a brutal experience, which in some cases can be fatal. Withdrawing from alcohol without any medical intervention can carry even greater risk than withdrawing from heroin (an opioid drug made from morphine).

A withdrawal can occur after the last ingestion of alcohol, but usually occurs within a six-hour window after cessation of alcohol consumption. By the twenty-fourth hour, an individual may experience temporary visual impairment, extreme anxiety symptoms, and even hallucinations; irregular heart rate and profuse sweating may also occur. On this, National Center for Biotechnology Information reports: “Hallucinosis, which may occur within one or two days of decreasing or abstaining from alcohol intake, is a complication distinct from DT’s. Patients with alcohol hallucinosis see, hear, or feel things that are not there even though they are fully conscious and aware of their surroundings. Moreover, hallucinosis is not necessarily preceded by various physiological changes (i.e., autonomic signs).”

From twenty-four to forty-eight hours, the risk of a seizure is likely to be the highest, including other aggressive symptoms (this period requires additional monitoring). Within twenty-four to seventy-two hours, delirium tremens can occur. Again, every individual is unique, and will have varying experiences whilst going through a withdrawa lfrom an alcohol dependency.

An alcohol dependent person will likely experience some or many of the following symptoms associated with a withdrawal:

  • Hand tremors
  • Irregular heart rate
  • Dehydration
  • Profuse sweating and/or chills
  • Heart palpitations
  • Nausea, fever, and aches
  • Vomiting
  • Headaches
  • Insomnia
  • Loss of appetite
  • Depression, anxiety, stress, and restlessness
  • Bouts of anger, rage, and mood swings
  • Hallucinations
  • Delirium tremens
  • Suicidal ideation

With respect to the importance of a competent health professional (such as our world-class team) monitoringan alcohol withdrawal,National Center for Biotechnology Information states: “The symptoms of withdrawal are not specific and easily can be confused with other medical conditions. Consequently, the clinician’s initial assessment also serves to exclude other conditions with symptoms similar to those of AW. Examples of such conditions include subdural hematoma (i.e., the collection of blood in the space between the membranes surrounding the CNS), pneumonia, meningitis, and other infections.”

The author continues: “Similarly, seizures and DT’s may be confused with other conditions that should be excluded during initial assessment. For example, DT’s, which represent an acute confusional state, can mimic delirium from other medical causes, such as encephalitis, meningitis, adverse effects of some medications, or Wernicke’s encephalopathy. Likewise, AW seizures must be distinguished from seizures resulting from other causes, such as mineral or electrolyte abnormalities, strokes, brain tumours, epilepsy, or subdural hematoma. Thus, a diagnosis of DT’s and AW seizures should be made only after other reasonable causes for these complications have been excluded.”

Opioid withdrawal

Opioids are powerful painkillers which in the short-term can help to ease the effects of extreme physical pain, for example after a traumatic injury or surgery. However, taking prescribed opioids for a longer periodcan increase the risk of abuse and addiction, such is the strength of this medication. An individual taking an opioid for acute short-term pain relief may experience mild symptoms whilst tapering off after, for example after atwo-week prescription. However, an individual dependent on/addicted to an opioid such as fentanyl (actiq) or oxycodone (oxycontin) will experience a painful withdrawal.

Healthline writes: “It’s important to remember that different drugs remain in your system for different lengths of time, and this can affect withdrawal onset. The amount of time your symptoms last depends on the frequency of use and severity of the addiction, as well as individual factors like your overall health.” The author continues:

“For example, heroin is typically eliminated from your system faster, and symptoms will start within twelve hours of last use. If you’ve been on methadone, it may take a day and a half for symptoms to begin. Some specialists point out that recovery requires a period of at least six months of total abstinence, during which the person may still experience symptoms of withdrawal.”

An opioid dependent person will likely have some or many of the following symptoms associated with a withdrawal:

  • Nausea and vomiting
  • Runny nose
  • Goose bumps and chills
  • Suicidal ideation
  • Anxiety and stress
  • Mood swings and bursts of anger/rage
  • Muscle twitching and tremors
  • Insomnia
  • Hot and cold flushes
  • Sweats
  • Muscle cramps
  • Watery discharge from eyes
  • Diarrhoea

Benzodiazepine withdrawal

Continued and consistent use of benzodiazepines can create a dependency/addiction. There are different stages of a benzodiazepine withdrawal: immediate withdrawal, acute withdrawal, and post-acute withdrawal (protracted withdrawal). The British Pharmacological Society reports: “Benzodiazepine use for as little as three to six weeks, even while adhering to therapeutic doses, is associated with the development of physical dependence, with between 15–44% of chronic benzodiazepine users experiencing protracted moderate to severe withdrawal symptoms upon cessation including emergent anxiety and depressive symptoms. For longer term use approximately 40% of people on benzodiazepines for more than six months will have a moderate to severe withdrawal, and the remaining 60% will have a relatively mild withdrawal syndrome if the drug is stopped suddenly.”

A benzodiazepine dependent person will likely experience some or many of the following symptoms associated with a withdrawal:

  • Loss of appetite and weight loss
  • Mild to moderate depression
  • Nausea
  • Nightmares
  • Anxiety/panic attacks
  • Restlessness
  • Sleep deprivation
  • Pins and needles
  • Sore eyes, sore tongue, and metallic taste
  • Agoraphobia 
  • Abdominal cramps, muscle tension, tight chest, fast heartbeat, sweating, trembling or shaking
  • Dizziness, headaches, blurred vision
  • Increased sensitivity to noise, small, taste, touch, and light
  • Loss of interest in sex
  • Tinnitus (ringing in the ears)
  • Vomiting

Other types of withdrawals from addictive behaviour

Withdrawal from process addictions such as pornography, sex and gambling will often produce symptoms during the cessation period because of the fluctuation of dopamine levels and rewiring in the human brain. These include anxiety, panic attacks, sleep deprivation, social paralysis, depression, loss of libido, fatigue, intrusive thoughts, and cravings.

At Addcounsel, we understand just how difficult it can be to arrest the progression of an addiction. We’re here to remind you that there is nothing to be ashamed of and that recovery is entirely possible. We adopt a unique and personalised approach to treatment. We will adapt your addiction treatment programme to your specific needs and medical history and support you throughout the process. Alongside substance abuse treatment, we also cater to a wide range of mental health conditions. If you’d like to find out more, contact our care team today. We are more than happy to answer any questions you might have and walk you through the admissions process.

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