Withdrawal

The Physical and Mental Burden of Recovery

WHAT IS WITHDRAWAL?

Withdrawal is a combination of physical and mental effects that can occur when someone stops taking a substance such as alcohol, prescription, or recreational drugs. Many drugs can create a dependence when misused or abused in a binge-like pattern. Symptoms of withdrawal can vary depending on the type of drug that is causing withdrawal and your biological make-up.

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Two Types of Dependence

There are two types of dependence that can occur from drug use. These two types are physical and psychological dependence.

Two Types of Dependence

Physical dependence occurs when the body develops a tolerance to a drug when it is used frequently over an extended period. Misuse or abuse of a drug can increase the likelihood of physical dependence. When the body adapts to a drug it will require higher doses for the drug to have an effect. When higher and higher doses of a drug are used, an increasingly stronger physical dependence will take hold. The body will begin to crave the drug and show symptoms of withdrawal when they haven’t taken it for a while.

Two Types of Dependence

Psychological dependence refers to behavioral patterns that are created by frequent drug use. This type of dependence occurs on a mental and emotional level. Frequent drug use may be occurring because an individual is trying to cope with other underlying issues they are having or things that are going on in their life. They may be using drugs to self-medicate or as a coping method rather than working on underlying issues. Underlying issues may be things such as mental illness, trauma, or issues in work or personal life. When using a drug to cope, psychological dependence can occur through feeling like the drug is helping and feeling like you can’t function without it. Someone may also develop behavioral patterns where their life begins to revolve around frequent drug use as it becomes normalized for them. When drug use starts to feel essential or becomes habitual, it can feel like a large mental burden that is constantly weighing on someone.

WHAT TO EXPECT?

When talking about withdrawal it’s not always easy to pinpoint exactly what to expect as many symptoms, reactions, and timelines will depend on the type of drug and your biological make-up. However, some common factors may occur that can give you an idea of what it is like and how the process will go.

Common Symptoms

Some of the common symptoms of withdrawal include nervousness, nausea, vomiting, anxiety, lethargy, irritations, and depressed mood. Working with a treatment center is usually a good idea to cope with these symptoms. Some symptoms can become dangerous and a treatment center will help give you the medical attention that’s needed. Many individuals who are experiencing withdrawal symptoms will experience cravings. These cravings come from a physical or mental point of having become dependent on a drug. An important thing to remember is that cravings are normal during this type of process and they will go away eventually. Different people will experience cravings in different ways. Some may be able to ignore it, while others may need to work on strategies to ignore temptations.

Timeline

The timeline for withdrawal symptoms will differ depending on the individual and the type of drug that is causing the symptoms. There are two phases to withdrawal symptoms called acute withdrawal and protracted withdrawal. Acute symptoms are the ones that appear initially and deal with physical dependence on a drug. An article by SAMHSA (Substance Abuse and Mental Health Services Administration) lists the following timeframe for acute withdrawal symptoms.

After the acute symptoms end, protracted withdrawal symptoms will begin. These are the symptoms that deal with psychological dependence and a behavioral therapy program will be helpful in recreating thought patterns and behavioral patterns that were developed when using drugs.

IS IT SAFE TO GO THROUGH WITHDRAWAL WITHOUT MEDICAL HELP?

Some people may attempt to go through withdrawal without medical help for various reasons. Some do not know where to go, don’t know what resources are available, or they fear discrimination. It is important to remember while there may be success stories from people who went through it alone, it may not be the best option for everyone, and treatment programs can do a lot of good. Withdrawal symptoms have the potential to be dangerous and can cause major health concerns. This is why you should consider going to a treatment center so you can get the proper care and rehabilitation. It’s important that you know you don’t have to go through this alone. If you’re unsure where to start you can contact SAMHSA’s National Helpline for information about what the first steps to recovery are and what resources are available in your area.

PROGRAMS FOR WITHDRAWAL

There are different types of treatment options available for recovery from substance use disorders. Treatment centers are often the best place to start as they can help guide you through the process and provide ways to cope with withdrawal symptoms. There are both residential and outpatient programs and the best fit will depend on the individual. Residential programs involve staying at a treatment center where you can remain in a completely sober environment away from temptations. Outpatient programs allow you to be home at night so you can still see your family. There are also medication-assisted programs that will be able to provide medications that can relieve some symptoms. Depending on the drug that is causing symptoms and your medical history this may or may not be an option. Speaking to a medical professional will help assist you on which option will be the best fit for your needs.

MEDICATIONS USED TO TREAT WITHDRAWAL OF COMMON SUBSTANCES

Certain medications can be used to provide relief from symptoms of drug or alcohol withdrawal. Depending on the type of drug causing withdrawal and the individual’s needs this may or may not be a good option.

Heroin

For heroin, three common medications may be used to treat opioid withdrawal symptoms. These include methadone, buprenorphine, and naltrexone.

Methadone

Methadone is an opioid, like heroin, and it can be addictive on its own, but under strict medical guidelines, it can help manage heroin withdrawal symptoms.

Buprenorphine

Buprenorphine is another medication that is used to treat opioid withdrawal symptoms. Buprenorphine is often viewed as a safer option than methadone and it has become the first medication for opioid withdrawal that can be prescribed in physician offices which makes it easier for people to get treatment.

Naltrexone

Naltrexone is used to block the effects of opioids by blocking opioid transmitters in the brain. This helps reduce mental cravings during opioid withdrawal as opioids will no longer have an effect.

Alcohol

For alcohol withdrawal symptoms the three main medications that can be used are Acamprosate, Disulfiram, and Clonidine.

Acamprosate

Acamprosate doesn’t decrease alcohol withdrawal symptoms, but it does affect the brain in ways that decrease the urge to drink. Acamprosate has been used by over 1.5 million patients and has shown overall positive results in managing compulsions while experiencing alcohol withdrawal.

Disulfiram

Disulfiram is another medication that is used for treating alcohol withdrawal. While it doesn’t help manage the symptoms, it does help as a deterrent to drinking. When Disulfiram is being taken it affects the body’s chemistry so when alcohol is consumed, it causes the individual to feel ill and not want to continue drinking. This has shown to have positive results in redirecting behavior patterns during treatment.

Clonidine

Clonidine is a medication used to treat anxiety and stress levels which can seem overbearing while experiencing alcohol withdrawal symptoms. Clonidine does this by lowering the heart rate and relaxing the blood vessels to calm someone down, which can do a lot of good to address the symptoms.

Meth

For meth withdrawal, three mediations that are commonly used are Modafinil, Paroxetine, and Remeron.

Modafinil

Modafinil has a low potential for addiction and has shown that it can help manage meth withdrawal symptoms. This medication will help lower cravings while learning skills to manage behavioral patterns that cause drug use.

Paroxetine

Paroxetine is an antidepressant that has had mixed results in treating meth withdrawal. It has been shown in some studies that it does reduce cravings that are caused by stopping meth use.

Remeron

Remeron is another antidepressant that has been shown in studies to help reduce cravings in people going through meth withdrawal.

Benzodiazepines

Xanax is a common Benzodiazepine that can lead to dependence and cause withdrawal symptoms. When treating Xanax withdrawal three medications that can help are Clonazepam, Diazepam, and Zolpidem.

Clonazepam

Clonazepam is a long-lasting Benzodiazepine that is less addictive than Xanax, It can help reduce cravings.

Diazepam

Diazepam is similar to Clonazepam in that it is a long-lasting Benzo that can help reduce cravings from Benzo withdrawal or during Xanax treatment. This can also help manage things such as Xanax withdrawal symptoms, as it will lower the anxiety and stress that would be caused by going off the drug cold turkey.

Zolpidem

Zolpodem has been shown in clinical studies to reduce things such as anxiety and insomnia that can be caused by Benzo or Xanax withdrawal.

THERAPY USED TO TREAT WITHDRAWAL

Behavioral therapy is very useful when treating drug or alcohol withdrawal. There are two types of behavioral therapy that are often used: Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).

Cognitive Behavioral Therapy

CBT is used to redirect behavioral patterns in someone who is recovering from substance use disorders and push them to more positive behaviors and outlets.

Dialectical Behavioral Therapy

DBT is used to move someone away from destructive activities or suicidal actions.

Motivational Interviewing

Motivational interviewing is another therapy option that focuses on the client, helps them create behavioral changes, and guides them to explore their feelings, doubts, uncertainty, or other underlying issues.

CONCLUSION

The process of recovery from alcohol or drug dependence and going through drug withdrawal symptoms isn’t easy, but you don’t have to go it alone. There are resources available and you can get through this. If you’re struggling to figure out what your first step should be you can contact SAMHSA’s National Helpline for information about what the first steps to recovery are and what resources are available in your area.