Identifying The Symptoms of Drug Withdrawal

Identifying the symptoms of drug withdrawal is a step toward recovery for you or a loved one. Here’s what you need to know.

Substance use disorder happens with a wide range of legal and illegal substances, such as:

• Alcohol;
• Cocaine;
• Hallucinogens;
• Inhalants;
• Marijuana;
• Methamphetamine;
• Prescription medications; and/or
• Opiates.

The type of drug used causes different symptoms than other drugs, including biological sex, how long someone experiences withdrawal symptoms, length of use, pre-existing medical conditions, and more.

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Identifying the Symptoms of Drug Withdrawal: What It Means To Experience Drug Withdrawal

Identifying the symptoms of drug withdrawal can be difficult, but having a better understanding helps. If someone has a physical dependence on a drug or substance, then stops using, they usually experience drug withdrawal.

Withdrawal is usually a combination of physical and psychological symptoms and often include:

• Anxiety and other mental health issues;
• Cravings for the drug or substance;
• Diarrhea;
• Insomnia;
• Nausea; and/or
• Vomiting.

Substance Use Statistics

• Cocaine, LSD, and marijuana are the most commonly used illegal drugs in the U.S.[1]
• 1 million people used heroin in the past year.
• 59.3 million people age 12 or older used illicit drugs in 2020.

Symptoms Of Withdrawal By Drug

Identifying the symptoms of withdrawal can vary based on biological sex, genetics, pre-existing conditions or illness, length of substance use, and more. Below we outline common withdrawal symptoms depending on the type of drug used.

Alcohol Withdrawal

Alcohol withdrawal and its related symptoms (AWS) often occur within hours of your last drink. However, the length and severity vary from person to person.

Stage 1 (Mild)

Anxiety, gastrointestinal issues, heart palpitations, headache, and/or insomnia are common with AWS in stage one.

Stage 2 (Moderate)

Along with stage one symptoms, you or a loved one may also experience confusion, increased blood pressure or heart rate, mild hyperthermia, and/or rapid, unusual breathing in stage two.

Stage 3 (Severe)

You may experience stage two symptoms, along with auditory or visual hallucinations, delirium tremens, disorientation, impaired attention, and seizures in stage three.

How long each stage lasts varies between people, but the following is a general timeline for alcohol use disorder detox:

• 6-12 hours after the last drink: You may begin to feel Stage 1 symptoms.
• 24 hours: Depending on the severity of their use disorder, some people begin to undergo auditory, tactile, or visual hallucinations.
• 24-72 hours: Some symptoms peak, plateau, or end, though some may last weeks. The risk of seizures is highest during this time period, as is delirium tremens.

Effects of Long-Term Alcohol Use

Long-term or excessive alcohol use [2] can cause a host of serious health issues and chronic diseases, such as:

• Breast, colon, esophagus, liver, mouth, rectal, throat, and/or voice box cancer;
• Cardiovascular issues, like heart disease and high blood pressure;
• Dementia, learning, and memory problems;
• Depression, anxiety, and other mental health issues; and
• Weakened immune system.

Opiate or Opioid Withdrawal

Codeine, Vicodin®, and OxyContin® are three common opioids to which people develop dependence and a substance use disorder. While some people become dependent in a short amount of time while others use longer before reaching their drug tolerance, stopping use induces withdrawal symptoms.

Opioid withdrawal symptoms, such as heroin or prescription painkillers, generally come in two stages — early and late. Although the symptoms you or a loved one may experience are far from comfortable, they’re not life-threatening. Most begin within 12 hours of the last use of opiate or 30 hours of the last exposure to methadone.

Early symptoms of opiate withdrawal may include:

• Agitation;
• Anxiety;
• Muscle aches;
• Increased tearing;
• Insomnia;
• Runny nose;
• Sweating; and/or
• Yawning.

Late symptoms of opiate withdrawal may include:

• Abdominal cramping;
• Diarrhea;
• Dilated pupils;
• Goosebumps;
• Nausea; and/or
• Vomiting.

Effects of Long-Term Opiate or Opioid Use

Long-term opiate or opioid use can cause several health conditions for you or a loved one, including:

• Anxiety, bipolar, depression, and other mental health issues;
• Hepatitis C;
• Increased tolerance, including substance dependence;
• Infectious endocarditis;
• Infertility in women;
• Life-threatening withdrawal symptoms in babies born to women taking opioids;
• Liver damage; and/or
• Opioid-induced hyperalgesia or worsening pain.

Benzodiazepine Withdrawal (Benzos, Xanax®, Klonopin®, Ativan®, etc.)

Benzodiazepines are central nervous system (CNS) depressants that increase neurotransmitters like gamma-aminobutyric acid (GABA) in the brain. As a result, you or your loved one feel drowsy or have a calming effect; benzos are used to manage anxiety, panic attacks, and other conditions. This can make identifying the symptoms of drug withdrawal more difficult.

Since each benzodiazepine has its own specific half-life that influences how long it takes to leave the bloodstream, the withdrawal symptoms may be intense or light, fast or slow. Symptoms for short-acting forms, like Xanax®, can begin within 12 hours of the last use, while long-acting forms, like Valium, may not appear for a few days. Without professional and qualified help, benzos withdrawal symptoms can last for several months or longer and include:

• Anxiety;
• Agitation;
• Hallucinations;
• Increased heart rate;
• Nausea and/or vomiting;
• Seizures;
• Sweating; and/or
• Trouble sleeping.

Effects of Long-Term Benzo Use

• Cardiovascular issues include reduced heart rate, blood clots, and cardiac arrest.
• Chronic withdrawal symptoms;
• Cognitive decline, including loss of coordination and memory;
• Liver damage and/or liver failure;
• Reduced breathing rate and hypoxia.

SSRI or Stimulant Withdrawal (Zoloft®, Lexapro®, Prozac®, etc.)

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressant and anxiety medications. Withdrawal symptoms, or discontinuation symptoms, usually only happen for people who abruptly stop taking the medication rather than tapering down the recommended dosage with their doctor or healthcare provider’s guidance.

One in five people who take an SSRI go through some level of withdrawal symptoms. Their symptoms may last one to three weeks.[3] People who have used the medication for years may experience symptoms for months, including [4]:

• Balance issues, including dizziness, lightheadedness, and vertigo;
• Flu-like symptoms, including achiness, fatigue, headache, lethargy, and sweating;
• Hyperarousal, including aggression, agitation, anxiety, irritability, jerkiness, and mania;
• Insomnia, including vivid dreams or nightmares;
• Nausea; and/or
• Sensory issues, including burning, electrical, shock, or tingling sensations

Effects of Long-Term SSRI Use

• Diminished sexual interest;
• Reduced blood clotting capacity;
• Loss of medication effectiveness; and/or
• Low risk of internal bleeding.

Cocaine Withdrawal

When cocaine withdrawal symptoms begin for you or a loved one depends on the form used, such as powder or crack. Crack cocaine often causes symptoms within hours of the last use, while powdered cocaine usually takes longer. The length of symptoms range from a few days to several weeks based on the severity and duration of use.

Cocaine withdrawal symptoms generally include:

• Anxiety;
• Changes in sleeping patterns, including hypersomnia;
• Cocaine or crack cravings;
• Depression;
• Fatigue;
• Increased appetite;
• Irritability;
• Paranoia; and/or
• Poor concentration.

Effects of Long-Term Cocaine Use

Along with needing high doses in greater frequencies to attain the same desired effects, long-term cocaine use can cause you or your loved one to experience the following [5]:

• Brain bleed and/or stroke;
• Cardiovascular problems, including chest pain, heart muscle inflammation, and aortic ruptures;
• Extreme weight loss and malnourishment;
• Gastrointestinal issues caused by reduced blood flow;
• Hepatitis C, HIV, and/or other infectious diseases;
• Loss of sense of smell;
• Nosebleeds;
• Sinus problems, including chronically inflamed sinuses and runny nose.

Methamphetamine (Meth) Withdrawal

How long meth withdrawal symptoms last depend on which stage you or a loved one is in. Acute withdrawal symptoms generally last 7 to 10 days, with symptoms decreasing over time. Subacute withdrawal lasts up to 14 days. Common emotional and physical symptoms include:

• Anxiety;
• Dry mouth;
• Fatigue;
• Hallucinations;
• Intense meth cravings;
• Low motivation;
• Muscle spasms;
• Paranoia;
• Psychosis;
• Skin sores; and
• Trouble sleeping.

Effects of Long-Term Meth Use

When it comes to long-term meth use, identifying the symptoms of withdrawal can be obvious but very difficult to deal with. Long-term methamphetamine use affects you physically and psychologically. Studies have found significant changes in the brain structure of those with a meth use disorder directly affecting cognitive function and health. Other effects and resulting health conditions include:

• Cognitive issues, like impulse control and concentration problems;
• Anxiety and depression;
• Dental and oral health issues, including gum disease and tooth decay;
• Intense anger and/or violent behavior;
• Loss of appetite resulting in extreme weight loss;
• Organ damage, including heart failure;
• Psychosis and delusions; and/or
• Skin sores and related skin infections.

Marijuana or Cannabis Withdrawal

Regular marijuana or cannabis use often leads to withdrawal symptoms for many people. Acute symptoms appear within one to two days, with symptom severity peaking within six days. You or your loved one may have most acute symptoms clear up within three weeks.

Yet, you may experience specific psychological symptoms up to five weeks after your last marijuana use. Withdrawal symptoms may include:

• Aggression, anger, and irritability;
• Anxious or nervous feelings;
• Decreased appetite or weight;
• Depression;
• Gastrointestinal issues, including abdominal pain, nausea, and vomiting;
• Headaches and sweating;
• Insomnia;
• Restlessness;
• Strange or unsettling dreams; and/or
• Tremors.

Effects of Long-Term Cannabis Use

Although the long-term effects of marijuana use depend on how old you or your loved one is, length of use, and potency, common effects include:

• Altered brain development in adolescents and teens;
• Respiratory issues, including a persistent cough, chronic bronchitis, and pneumonia;
• Cognitive issues in children exposed while in-utero;
• Temporary hallucinations and paranoia; and/or
• Worsened schizophrenia symptoms.

Substance Abuse Treatment

A comprehensive and holistic approach to substance abuse treatment options is the best way to ensure you or your loved one are on the path to recovery. We work with various substance use disorder specialists and support professionals to deliver the health care needed in these situations.

Inpatient Alcohol and Drug Detox

Whether you or your loved one need a few days or weeks, our staff provides personalized care during detoxification. We understand monitoring any alcohol and drug withdrawal symptoms during this time needs to be tailored and supportive.

Long-Term Outpatient Care

Our outpatient care focuses on support following you or your loved one’s initial stay. We use an encompassing approach that includes research-validated techniques.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more