Withdrawal
Detoxification or withdrawal (also known as detox) is the process of cutting back, or cutting out, the use of alcohol or other drugs.
Your body will need to adjust to working without the drug in your system, so you may have a range of symptoms — some minor, and some serious.
Sometimes medication is used to treat the symptoms — this is known as pharmacotherapy.
What symptoms can I expect during withdrawal?
Cravings are caused by a link between the drug and its positive effects being “remembered”. The brain learns that the easiest and quickest way to feel good is by using the drug, and this becomes a way of dealing with problems and avoiding bad feelings.
Cravings can come and go. They are sometimes weak, and sometimes quite strong. You will need to learn to manage cravings as they can still occur many years after you have stopped using the drug.
Other symptoms are shown in the table below:
| Alcohol |
Loss of appetite, nausea, insomnia, anxiety, irritability, confusion, sweating and tremors.
In severe cases, convulsions, cramps, vomiting, delusions, hallucinations and, occasionally even, death.
|
| Amphetamines |
Hunger, extreme fatigue, anxiety, irritability, depression, long but restless sleep, nightmares, severe distress and panic.
|
| Benzodiazepines |
Headaches, aching or twitching muscles, tremor, feeling faint or dizzy, nausea, vomiting, stomach pains, bizarre dreams, sleep disturbance, fatigue, impaired concentration, anxiety, irritability, altered perception and heightening of senses.
Less commonly: delirium, delusions, hallucinations, seizures and paranoia.
|
| Cannabis |
Sleep problems, irritability, loss of appetite, weight loss, nervousness, anxiety, sweating and upset stomach. Sometimes chills, increased body temperature and tremors.
|
| Cocaine |
Usually occurs in three phases:
- "Crash" – these symptoms occur in the first few days of withdrawal: agitation, depression or anxiety, intense hunger, intense craving for cocaine, insomnia or prolonged sleep disturbances, extreme fatigue and exhaustion.
- "Withdrawal" – these symptoms can last up to ten weeks: intense cravings for cocaine, lack of energy, anhedonia (inability to feel pleasure), anxiety and angry outbursts.
- "Extinction" – intermittent cravings for cocaine can last indefinitely.
|
Ecstasy
(MDMA) |
Cravings, sleepiness, anxiety, depression, loss of concentration, insomnia, restlessness, agitation, general aches and pains.
|
GHB
(gammahydroxybutyrate) |
Confusion, agitation, anxiety, panic, feelings of doom, paranoia, insomnia, tremors, muscle cramps, perspiration, delirium, hallucinations and tachycardia (rapid heartbeat).
Sudden withdrawal from high doses can result in bowel and bladder incontinence and blackouts.
|
| Heroin |
Craving for heroin, restlessness, yawning, crying, diarrhoea, low blood pressure, stomach and leg cramps, muscle spasms, vomiting, goose bumps, runny nose, increased irritability, insomnia, loss of appetite, elevated heart rate and depression.
Chronic depression, anxiety, insomnia, loss of appetite, periods of agitation and craving for the drug can last for months or years.
|
Ice
(crystal methamphetamine) |
Craving for ice, disorientation, poor concentration, decreased energy, apathy, limited ability to feel pleasure, extreme fatigue and exhaustion, headaches, general aches and pains, hunger and increased appetite, disturbed and restless sleep, often interrupted by nightmares.
|
| Inhalants |
Mild symptoms begin 24–48 hours after stopping use, and may last from 2–5 days. May include: hangover, headache, nausea, stomach pain, tiredness, shakiness, tremors, cramps, hallucinations and visual disorders, such as seeing spots. |
| Ketamine |
Chills, intense cravings, restlessness, nightmares, anxiety, tremors, sweating, irregular and rapid beating of the heart, depression, tiredness, decreased appetite.
|
LSD
(lysergic acid diethylamide) |
Cravings for hallucinogens, fatigue, irritability, reduced ability to experience pleasure.
|
| Tobacco |
Craving for tobacco, irritability, agitation, depression, anxiety, insomnia, disturbed sleeping patterns, increased appetite and weight gain, reslessness, loss of concentration, headaches, coughing and sore throat, body aches and pains, stomach and bowel upsets.
|
Is withdrawal safe?
Medical supervision may be needed to make sure you go through withdrawal safely. If you are considering withdrawal, be sure to discuss this with your doctor or with an alcohol and other drug treatment service.
It is not usually dangerous, but some people do have more serious symptoms, like those in the table below.
| Alcohol |
- seizures/fits*
- disorientation
- delirium tremens (DTs)*– This can involve a range of symptoms from mild to severe (even life threatening).
|
| Benzodiazepines |
- seizures/fits*
- disorientation.
|
| *Delirium tremens, seizures and fits would be considered medical emergencies and an ambulance should be called. |
How long will it take to go through withdrawal?
This can depend on many things, including the type of drug, how long you have been using it, whether other drugs have been used, your general health and the setting where you have been withdrawing.
Generally, it will last from a few days to a few weeks, but some symptoms, such as cravings, can continue for a much longer time.
Where can I go for withdrawal?
It is important to be in a safe and supportive environment when going through withdrawal. Speak to your doctor, health practitioner or a drug and alcohol information service for advice on which setting would be best for your particular needs. They will probably suggest one of the following:
-
Home withdrawal is usually provided by a team including your doctor, a nurse and a support person such as a friend or family member. This may be a good choice if your withdrawal is likely to be uncomplicated.
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Outpatient withdrawal may be your best choice if you don’t need to be admitted to a residential service. It will involve intensive individual consultations over a short period of time, along with ongoing counselling and support.
-
Residential withdrawal will involve 5 to 10 days in a residential withdrawal unit or hospital with staff to help you 24 hours a day. They can help you during withdrawal, and afterwards, to prevent relapse.
Some residential units do not allow you any contact with the outside world for a period of time. This helps you to focus on your treatment, rather than worrying about what is happening at home. It also keeps you out of contact with people who use drugs, as this can cause cravings.
How can I prepare for withdrawal?
To give yourself the best chance of success in withdrawal, it is a good idea to take some time to prepare. Read our tips for preparing for withdrawal.
If you will be acting as support person for someone going through the withdrawal process, read our tips for helping a friend or family member through withdrawal.
Last updated: 30 June 2012
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