Body Detoxifying SymptomsAnna Ciulla
Substance abuse disorder is a serious disease that afflicts millions of people nationwide. Every individual reacts differently to drug abuse, experiencing a unique combination and severity of effects. Yet the common thread is that users, once suffering from addiction, will experience withdrawals if they do not remove the substance at hand. While withdrawal symptoms will range from user-to-user, every patient, in one capacity or another, will feel the effects of detox.
What is Detox?
Detoxification is the first step in any recovery program and, regardless of the drug of choice, there are associated symptoms that carry serious risk to the user’s physical and psychological well-being.
Medical detox is a controlled process that is supervised by medical professionals with the training and intention to achieve a safe level of physical stability within a client so that the psychological aspects of drug or alcohol abuse can be addressed effectively. Anyone who has developed a dependence on a substance, particularly alcohol, opiates, or benzodiazepines, is urged to detox under the supervision of a trained detox specialist to avoid any adverse consequences.
Factors That Influence the Duration of Symptoms
While the specific symptoms of withdrawal will vary depending on the substance that has been abused, the factors that affect the duration of these symptoms remain consistent. There are six factors that affect the duration of symptomology (during detox), and each one can be categorized to fit the biopsychosocial model of addiction.
Length of Abuse
The length of time that a substance has been abused will have a heavy influence on how long detoxification symptoms will last. Simply put, the longer the duration of abuse, the longer withdrawal symptoms tend to last.
Type of Substance Abused
Duration of withdrawal symptoms will also be determined by the type of substance abused. All substances are not created equal. Certain drugs are longer lasting than others.
Method of Abuse
The method with which a substance is typically administered is another factor. Common methods of administration include snorting, smoking, injecting, and swallowing. Generally speaking, methods that allow a substance to cross the blood-brain barrier more efficiently result in heightened effects, which tends to lead to higher levels of dependence and thus more severe withdrawal symptoms.
Amount of Substance Administered
Those who consume more of a given substance are more susceptible to developing dependence and tend to experience a longer, more intense period of withdrawal.
It is an unfortunate truth that some people are genetically predisposed to developing dependency. In some cases, an individual’s brain chemistry will react more strongly to the introduction of a substance of abuse, causing them to experience the effects of the substance more acutely than others—which prompts them to continue using. In other cases, individuals have a natural tolerance for a particular substance, necessitating a greater dose to experience effects and fostering dependence from the sheer volume being consumed.
Medical and Mental Health Factors
Medical factors, particularly those that warrant prescription medication to mitigate symptoms, will play a part too. Also, those who experience mental health issues often turn to substances in order to cope with their struggles. Both can lead to addiction and are likely to factor into the experience of withdrawal.
Acute Withdrawal Timeline
As we’ve mentioned, every substance is different in terms of how long it takes for acute withdrawal symptoms to manifest (onset of symptoms) and how long symptoms tend to persist (duration of symptoms). While there is some variation from person to person, onset and duration tend to occur as follows:
- Alcohol: Alcohol withdrawal tends to begin about 8 hours after the last drink is consumed. Peak symptomology occurs within 24-72 hours.
- Cocaine: Withdrawal begins within minutes to hours of the last dose, peaks in the following 2-3 days, and may persist for 1-10 weeks.
- Benzodiazepines: Withdrawal tends to begin within 1-4 days. In some cases, symptomology may last for months or years if not treated.
- Prescription Opiates: Withdrawal symptoms begin to manifest 8-12 hours post-cessation and last approximately 5-10 days.
- Heroin: Heroin withdrawal will ensue within 12 hours after the last dose is administered. Peak symptoms will occur between 24-48 hours and last up to one week.
Heroin is a highly potent opiate that induces feelings of euphoria (happiness), a sense of well-being, and works as an effective analgesic (painkiller). Opiates, in general, are considered to be highly addictive, and the effects of heroin sit atop the list. Side effects of heroin intoxication include drowsiness (often referred to as “nodding out”), relaxation, and constipation.
Acute withdrawal from heroin produces side effects that are both physical and psychological in nature. Physical side effects typically include those commonly associated with flu-like fatigue and fever. Users have also been known to experience muscle aches, sweating, runny nose, and insomnia in the early stages.
The later stage of heroin withdrawal will often involve physical symptoms including:
- Abdominal cramps
- Dilated pupils
The experience of psychological symptoms may begin and persist throughout both the earlier and later stages of acute withdrawal. The most profound of these are the experiences of agitation and anxiety.
Detoxing From Heroin
Withdrawaling from heroin carries with it some serious health risks that should be noted by anyone who is considering going through the process. Vomiting and diarrhea are two of the most common symptoms of opiate withdrawal, and, when severe, both can cause other complications including dehydration and hypernatremia (high levels of sodium in the blood). Without medical supervision, either of these conditions has the potential to cause heart failure which, as you might guess, can be fatal. It is strongly recommended that anyone choosing to detox from heroin or other opiates do so under the care of medical professionals to mitigate risk. With that being said, it is rare that detoxing from heroin proves fatal.
Benzodiazepines or “benzos” comprise a class of prescription drugs that are commonly ordered by psychiatrists to treat anxiety, panic disorder, and seizures. They are also occasionally prescribed as sleep aids or muscle relaxants. They act on GABA receptors in the central nervous system which, among other things, are responsible for activating the “fight or flight” response. When this system becomes overactive, it results in an influx of stress and anxiety. There are a number of drugs in this class, many of which have become heavily abused, including:
- Alprazolam—Brand name: Xanax
- Diazepam—Brand name: Valium
- Clonazepam—Brand name: Klonopin
- Lorazepam—Brand name: Ativan
- Triazolam—Brand name: Halzion
- Oxazepam—Brand name: Serax
- Chlordiazepoxide—Brand name: Librium
Once dependency has developed, the removal of the drug causes a significant withdrawal that results in a host of difficult side effects. Benzodiazepines work in the same pathogens of the brain as alcohol—in which case, their withdrawal symptoms are eerily similar. Many of these are psychological in nature and impose considerable distress upon the user. Some of these include:
- Panic attacks
- Short-term memory loss
- Difficulty concentrating
Other acute withdrawal symptoms manifest themselves physically. These include:
- A headache
- Disturbed sleep
As you might imagine, any one of these side effects, or a combination of side effects, can be extremely uncomfortable and cause a substantial amount of distress. Furthermore, given the chronic nature of many anxiety disorders, which benzodiazepines are designed to treat, symptoms of withdrawal can linger. As with any substance of abuse, treatment is recommended to aid in recovery. However, the protracted withdrawal associated with benzodiazepines necessitates it.
Detoxing from Benzodiazepines
In addition to the extreme discomfort and distress that can result from the detoxification process, benzodiazepines pose a serious risk to users’ long-term well-being. As with opiates, there is a very real risk that withdrawal could induce seizures, which have the potential to cause irreversible brain damage or death. It is critical that anyone entering the detoxification process for benzodiazepines do so under the care of trained medical staff.
Cocaine is a powerful stimulant drug that is commonly found in two different forms: powder, which is typically snorted but can also be smoked or injected; and rock (crack) which is typically smoked. The high from either is very short-lived, in comparison to other drugs and produces feelings of euphoria and self-confidence along with heightened levels of energy. Cocaine detox is observed in three distinct phases, the first one beginning within minutes to hours after the last dose.
- Crash Phase: This initial period of withdrawal can last anywhere from 9 hours up to four days. Once the acute effects of the cocaine have worn off, users may notice a significant increase in appetite, sleep for extended periods of time, and experience feelings of depression or irritability.
- Acute Withdrawal: The acute withdrawal phase can continue for up to 3 weeks after the crash phase. Acute withdrawal is characterized by depression, insomnia, fatigue, irritability, and cravings.
- Extinction Phase: Arguably the most dangerous phase, the extinction period commonly includes cravings, depression, and even suicidal thoughts that occur periodically over the course of several months.
The main difference between stimulants like cocaine and other classes of drugs—during the detoxification process—is a distinct lack of physical symptoms. Most of the symptoms manifest themselves psychologically, creating serious emotional turmoil in the mind of the one experiencing it. Because of this, it is recommended that users seek out the help of a mental health professional, specifically, in order to get the psychological support necessary to help them through the detox process and recovery.
Alcohol is the most widely abused substance in the United States and, contrary to what you might believe, actually causes some of the most dangerous side effects during the alcohol detox process. The range of detox symptoms from alcohol is vast, starting from what could be described as a severe and extended hangover and ending on a condition called delirium tremens, which can prove fatal. As with other substances of abuse, the longer and heavier one drinks, the higher the risk becomes of experiencing these potentially life-threatening symptoms and cravings.
The process of detoxifying from alcohol comes with a laundry list of potential symptoms, both physical and psychological. Physical symptoms include:
- A headache
- Brain fog
- Elevated heart rate
- Muscle aches
- Loss of appetite
- Pallid skin
- Shallow breathing
- Clammy skin
It is exceedingly common for those who have recently ceased drinking to experience a number of these symptoms concurrently which, as you can imagine, can be extremely uncomfortable or even incapacitating—particularly when combined with psychological symptoms such as:
- Trouble concentrating
- Moods swings
Delirium tremens, which is commonly referred to as the “DT’s” is the most serious condition that can arise during the detoxification process. It typically occurs only to those who are abstaining from alcohol after a prolonged period of heavy use. It is characterized by some less serious effects including fever and agitation, but its signature effects are infinitely more dangerous. Severe confusion, hallucinations, and seizures are the trademark of this condition, and the latter has the potential to become fatal without a proper detox program. It is imperative that anyone with a strong dependence on alcohol who wishes to begin the detoxification process do so under medical supervision to avoid these risks. If you are someone who is highly dependent on alcohol, do not try to quit cold turkey. Seek professional help from a reliable treatment center to avoid further complications.
The range of symptoms that arise during the detoxification process varies across the board; from the mildly irritating to the potentially life-threatening, it’s the drug at hand that holds all the secrets. Every substance of abuse has its own set of acute effects and by extension, its own set of withdrawal effects.
One thing to keep in mind is that everyone is going to have a different experience with substances abuse due to his or her own unique brain chemistry. Everything discussed above is based on the collective but subjective experiences of millions of users nationwide. There are no hard and fast rules; nothing is written in stone.
What is most important is that anyone with drug abuse issues who are seeking recovery—the first step of which is the detoxification process—gains a basic understanding of the process and the potential risks involved. There are so many resources available to help you through this process and beyond, and we urge you to seek them out so that you may avoid any adverse consequences and give yourself the strongest chance at a safe and healthy recovery.