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Withdrawal

What is withdrawal?

What can I expect from withdrawal?

Is withdrawal safe?

How long will it take to go through withdrawal?

Where can I go for withdrawal?

How can I prepare for withdrawal?

How can I help someone through withdrawal?

Further information

 

What is withdrawal?

Withdrawal or detoxification (also called detox) is the process of cutting back, or cutting out, the use of alcohol or other drugs. Withdrawal symptoms can range from mild to severe, and differ depending on the duration of use, type of drug, age, the person’s physical and psychological characteristics and the method of withdrawal. A person could develop physical or psychological dependence on a drug, or both.

Physical dependence

Physical dependence occurs when someone has taken a drug for a period of time and comes to rely on it, because if it’s not taken withdrawal symptoms will appear. 

Psychological dependence

Psychological dependence occurs when a person believes they need the drug to function. This could be in certain situations, such as at a party, or it could be all the time.

What can I expect from withdrawal?

Withdrawal symptoms

Your body will need to adjust to working without the drug in your system, so you may experience a range of symptoms, some minor, and some serious.

Find withdrawal symptoms for specific drugs.

Cravings

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. Managing cravings involves learning distraction and relaxation techniques such as reading, watching a movie, meditating or exercising.

Sometimes medication is used to treat withdrawal symptoms – this is known as pharmacotherapy.

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 especially important that you get medical assistance when withdrawing from alcohol, GHB, benzodiazepines or ketamine.

How long will it take to go through withdrawal?

This can depend on many factors, 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 go through withdrawal.

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 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 not likely to be complicated.

  • 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 with a health professional 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 partners, friends or family 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 a successful withdrawal, it is a good idea to take some time to prepare.

Doing some preparation before you start your withdrawal will give you the best chance of success.

  • Talk with your doctor, or an alcohol and other drugs treatment service, and make sure you have a support person, and a supportive environment, during the withdrawal process.

  • Write down your own personal list of reasons for going through withdrawal. List the advantages and disadvantages of using or giving up the drug. This can help to keep you motivated when the withdrawal seems too hard and you want to give up.

  • Plan for what to do if you end up using drugs during withdrawal. This does happen sometimes and is a critical stage in treatment. You may choose to give up treatment and go back to using the drug, or you could think of it as a setback and continue with the withdrawal. It will be important to talk about why this happened, what worked well, what did not, and what could be done differently next time.

  • Remember that when you have been taking a drug regularly, your body gets used to it, so you need more of the drug to feel the same effect. If you stop taking the drug, even if it is only for 2 or 3 days, you may develop a lower tolerance, so if you begin taking it again, there is a real risk of overdose.

  • Try to eat a healthy diet, even though you might crave junk food. This can reduce mood swings that are often part of withdrawal.

  • Drink between 1 and 2 litres of water per day, but not more than 3 litres.

  • You may need a multivitamin supplement if you feel unwell and can't eat much.

  • Plan to keep busy so you don’t have time to dwell on how you are feeling. Remember you probably won’t be able to concentrate for long periods, and your memory may not be working very well. Easy activities like watching TV or movies, walks, reading magazines and short trips may be good activities to try.

  • Learn some basic stress management techniques, such as relaxation, exercise, massage or just talking with your support person about how you feel, to help overcome anxiety during this time.

How can I help someone through withdrawal? 

If you are supporting a friend or family member through the withdrawal process, it's a good idea to do some preparation beforehand.

Understand the process 

Talk to the health practitioner supervising the withdrawal to make sure you are clear about your role and understand what you will need to do to help the person through their withdrawal.

Familiarise yourself with the effects of the drug that your friend or family member is using.

Find withdrawal symptoms for specific drugs.

Get support for yourself 

Have support organised for yourself, and make sure there is someone you can talk to if things get difficult.

The state and territory alcohol and drug information services can direct you to counselling, additional information and referral to services. These information services can put you in touch with specialist family help lines and support groups. They are often run by friends and family members of people who use drugs, so they will understand your situation.

Be there during the tough times

  • Try to stay positive for your friend, if they begin to question why they are going through the process. Challenging any illogical thoughts during withdrawal is a very important function of a support person.

  • Encourage them to read through their personal list of reasons for going through withdrawal if they begin to have unpleasant symptoms, or if they are questioning whether withdrawal was really a good idea.

  • Help them to deal with their relapse if they begin to use the drug again during withdrawal. It can be useful to make a plan for how they will deal with relapse before they begin withdrawal.

  • Be on the lookout for overdose if they do relapse. When a drug is taken regularly, people will build up a tolerance to the drug so that they will need a greater dose to feel the same effect. Even when the drug is stopped for only 2 or 3 days, tolerance may be affected, so if they return to using the drug in the same amounts, there is a real risk of overdose.

  • Encourage them to eat a balanced diet as this can reduce mood swings that are often a feature of withdrawal.

  • Remind them to maintain their fluid intake. 1 to 2 litres of water is recommended, but they should not have more than 3 litres a day.

  • Suggest a multivitamin supplement if they are struggling to eat.

  • Keep them busy so they don’t have time to dwell on how they are feeling. Remember they will have a short concentration span, and their memory may not be functioning very well. Watching TV or movies, walks, short car rides, reading magazines and short trips may be good activities to try.

  • Help them to manage stress by using basic techniques such as talking, exercise or massage.

  • Know the rules of the unit. If your friend or family member is preparing for residential withdrawal at a hospital or withdrawal unit, make sure you find out whether there are restrictions on visiting, or contacting them, and what items may be brought in to the unit.

Further information

Resources

 

Adapted from Your guide to drug withdrawal by the Australian Drug Foundation and Turning Point Alcohol & Drug Centre, 2012.

Last updated: 28 March 2014

 
Information you heard is intended as a general guide only. This audio is copyrighted by the Australian Drug Foundation. Visit www.DrugInfo.ADF.org.au for more