Many people who want to stop using drugs or alcohol have a common question: how long does withdrawal last? This is not surprising since no one wants to deal with unpleasant mental or physical symptoms even if they’re only temporary and necessary for recovery.
However, the reality is that alcohol and drug detox symptoms vary widely in their severity and duration. Each individual will have a different experience when going through withdrawal. The key determining factor is the drug to which you’re addicted. However, several other factors come into play including the length of time you used the drug and personal characteristics like metabolism and genetics.
Therefore, some people will start to experience withdrawal symptoms within a few hours, and others will be okay for a few days. These symptoms can last for days, weeks, or even months in cases of severe addiction to some types of drugs.
Since withdrawal symptoms can be highly uncomfortable and even painful, many people relapse while trying to get clean. However, undergoing medically supervised detox significantly reduces the discomfort and danger. People who get medical assistance during withdrawal and then move on to intensive treatment are more likely to succeed at maintaining their sobriety.
Before we detail the common withdrawal symptoms associated with various substances, let’s look at physical dependence and tolerance. This will make it easier to understand why drug withdrawal happens the way it does.
What is Physical Dependence?
If you can’t stop using a substance without experiencing withdrawal symptoms, you are deemed physically dependent. People who use drugs or alcohol regularly typically develop tolerance. This is when you need to take more of the substance over time to feel the same effects. Physical dependency worsens as your tolerance increases.
It is believed that tolerance occurs because the body tries to achieve homeostasis or a stable level of functioning. The connections in your brain change when you use drugs or alcohol repeatedly. This helps the brain to adapt to the effects of the substances and maintain homeostasis.
It is because your brain adapts that you don’t get the same high from the same amount of alcohol or drugs. When you take more, you feel intoxicated or high because your body’s homeostasis is thrown off. Naturally, when you stop drinking or using drugs, your brain and body are forced to adjust yet again and this can result in withdrawal symptoms.
What Happens During Alcohol and Drug Withdrawal?
Withdrawal symptoms vary widely but there are certain things that people experience regardless of which substance they’ve become addicted to. For example, many people experience rebound effects which are the opposite of the drug’s effects. Therefore, if you are withdrawing from opioids, you may experience lots of pain. If you’re withdrawing from stimulants, you may be very lethargic.
People in withdrawal usually also display decreased tolerance. Tolerance drops rapidly and this is why relapse can lead to overdose. Individuals who relapse may use the same amount of the drug that they used before they stopped taking it, not realizing that their tolerance isn’t what it used to be.
Depression is also common. People withdrawing from any substance can feel unmotivated and without drugs or alcohol all in their systems, they are unable to feel pleasure. This happens because the brain gets accustomed to the excessive dopamine levels brought on by substance abuse. Without it, the individual can’t feel happy.
In addition, drug withdrawal is often characterized by an irregular heartbeat, changes in blood pressure, and irregular breathing. This happens because of changes to the autonomic nervous system.
How Long Does Withdrawal Last?
Several factors affect the length of time that withdrawal syndrome lasts. In addition to the drug that you took, the experience you’ll have depends on:
- How much of the drug you used
- How you took the drug
- Whether you used multiple substances
- How long you abused the drug
- Your weight and genetic makeup
- Whether you have a family history of substance abuse
However, let’s look at the withdrawal timelines for some of the most commonly abused substances.
How Long Does Alcohol Withdrawal Last?
On average, withdrawal symptoms begin about eight hours after the last drink, but in chronic, heavy users, they can start within two hours of the person having their last drink. For some people, symptoms take a full day to kick in. Alcohol withdrawal symptoms last for one to several weeks depending on the severity of the symptoms. Mild to moderate symptoms tend to last for a week or two but severe symptoms can go on for several weeks or longer.
The severity of the symptoms is largely dependent on the severity of the addiction. If you were a light to moderate drinker, your withdrawal symptoms will likely be mild to moderate. Still, you should be monitored by a doctor because you may still be at risk of experiencing seizures, especially if you abused alcohol for a long time. If you were a heavy drinker, you are more likely to experience seizures, psychosis, confusion, and other life-threatening symptoms.
Meanwhile, if you abused alcohol every day for a decade or more, you’re more likely to be affected by withdrawal symptoms than someone who was only dependent on alcohol for a few months. Also, if you have additional mental health problems, you’re more likely to experience uncomfortable side effects than someone who is otherwise in good health.
Stages of Alcohol Withdrawal
There are three stages in the alcohol withdrawal process but not everyone experiences all of them.
It’s almost impossible to predict what will happen to a person when they stop drinking. However, in the first stage, people may experience:
- Abdominal pain
- Loss of appetite
- Mood swings
- Heart palpitations
Stage one usually lasts for about a day and for many people, these symptoms are quite mild. However, vomiting can lead to dangerous levels of dehydration.
The second stage typically begins a day after an individual stops drinking but it can also take up to three days to start. Whenever it begins, this stage involves more serious symptoms such as:
- Increased body temperature
- Breathing problems
- High blood pressure
- Abnormal heart rate
These symptoms last for two to three days. The sweating can lead to dehydration which can cause additional health problems. That’s why medical attention is so important.
The final stage of alcohol withdrawal is the most dangerous and it can be deadly. Symptoms such as hallucinations, seizures, and high fever typically begin about three days after the last drink and they can last for weeks.
Any one of these symptoms is dangerous and requires medical attention. When they all occur together, the outcome can be even worse. People who experience seizures can fall, suffer head injuries, or choke. Medical supervision is absolutely essential.
How Long Does Benzo Withdrawal Last?
Benzodiazepine withdrawal shares some similarities with alcohol withdrawal. If a person who’s addicted to Xanax or Valium suddenly stops using it, they may experience withdrawal symptoms that come on rapidly. Withdrawal can result in extreme confusion and potentially fatal seizures.
If you’re withdrawing from benzos, you will likely feel anxious and irritable for several weeks. During the first week, you may also experience hand tremors and headaches. Insomnia affects many people.
Other possible symptoms include:
- Muscle spasms
- Grand mal seizures
- Racing pulse
- Nausea or vomiting
- Aches and pains
- Panic attacks
- Hypersensitivity to stimuli including light and touch
- Goosebumps, a crawling sensation on the skin, and other unusual bodily sensations
- Difficulty with concentration and memory
- Blurred vision or flashes of light
Onset and Duration of Benzodiazepine Withdrawal Symptoms
The onset of withdrawal depends on which drug is involved. Alprazolam (Xanax) and lorazepam (Ativan) are short-acting so they leave the body quicker. Therefore, withdrawal symptoms can start within 8 to 12 hours. However, longer-acting benzodiazepines like clonazepam (Klonopin) stay in the system longer. It can, therefore, take a day or two for symptoms to start.
With short-acting benzos, withdrawal symptoms peak on the second day and typically start to get better by the fourth or fifth day. However, some people experience these symptoms for several weeks.
About 10 to 25 percent of chronic benzo users experience protracted withdrawal. This is a long-term withdrawal syndrome in which symptoms come and go over several months. The symptoms are milder than they are during acute withdrawal.
Factors Influencing the Severity of Symptoms
Withdrawal symptoms don’t only occur in people who abuse benzodiazepines. Even people who take small, therapeutic doses for a month can experience negative side effects when they stop using one of these drugs. Among people who suddenly stop taking benzos after more than six months of use, 60 percent experience mild symptoms, and 40 percent experience moderate to severe symptoms.
The severity of the symptoms varies depending on:
- The dosage
- The duration of use
- Whether you took other sedatives
- Whether you took other benzos
- Whether you have a history of substance abuse
- Whether you’re quitting more than one substance at a time
Addiction treatment professionals usually recommend that individuals gradually reduce their dosage with medical guidance rather than quit cold turkey. This allows for greater management of the symptoms. If you’ve been taking a benzodiazepine for more than six months, abruptly stopping your use can lead to delirium and grand mal seizures. This is why a healthcare professional should be involved in the process.
How Long Does Opioid/Opiate Withdrawal Last?
Opioids include heroin, hydrocodone, oxycodone, and fentanyl. Though withdrawal from these drugs can be distressing, the symptoms aren’t usually fatal. The risk of seizures is also typically lower than that associated with withdrawing from other drugs. However, if you have a pre-existing condition that puts you at increased risk of seizures, the likelihood is higher.
Tolerance to opioids increases very quickly so if you’ve been abusing opioids for a long time, your tolerance may be very high. This means you may be taking a dosage that would be fatal to a person with lower tolerance levels.
Relapse is actually the biggest risk associated with opioid withdrawal. Since your tolerance will decrease significantly when you stop using, relapsing with the same dose could be highly dangerous or even fatal. Opioid withdrawal also puts you at risk of dehydration and emotional distress leading to self-harm.
In people with mild to moderate opioid addiction, withdrawal symptoms may not appear for a day or two. However, chronic, heavy users may begin to experience symptoms within hours.
Symptoms can last from a few days to a month and they typically occur in two phases. The first phase may be characterized by:
- Extreme opioid cravings
- Excessive sweating
- Lethargy and lots of yawning
- Runny nose
- Restless leg syndrome
The second phase starts after a day or two and the symptoms can be more intense. They include:
- Rapid heartbeat
- High blood pressure
- Dilated pupils
- Abdominal cramps
- Nausea and vomiting
Opioid Withdrawal Timeline
The symptoms mentioned above can be painful and highly unpleasant. However, they typically start to improve within 72 hours and acute symptoms decrease significantly within a week. The longer-lasting symptoms are usually behavioral and emotional rather than physical.
During medical detox, many patients benefit from medication-assisted treatment and opioid replacement medicine.
How Long Does Stimulant Withdrawal Last?
Stimulants include prescription drugs such as Ritalin as well as substances such as meth, cocaine, and amphetamines. The withdrawal symptoms associated with these drugs are usually more emotional than physical. However, people may experience lethargy, nervousness, and sweating. Individuals who are withdrawing from meth are especially likely to experience a crash phase that may include multiple days of extreme sleepiness.
Most people withdrawing from stimulants experience cravings and extreme mood swings. These symptoms cause many people to relapse. During, medical detox, individuals are given medication to control their cravings and reduce lethargy. Depression and apathy are typically addressed during long-term treatment.
Symptoms can begin right after an individual’s last dose and they can continue for up to five months.
Stimulant Withdrawal Timeline
People who are addicted to stimulants may feel sad, anxious, and agitated immediately after they stop using. Drug cravings are also likely to be intense. After this, mental and physical exhaustion will kick in along with worsening symptoms of depression.
About 12 hours after the initial crash phase, the severity of symptoms may increase, and this can last for anywhere between 96 hours and several weeks. The duration of the side effects varies depending on which stimulant is involved. The depressive symptoms associated with cocaine withdrawal tend to ease up within a few hours but those linked to methamphetamine usually last much longer.
One of the main dangers during stimulant withdrawal is that the individual experiences depression that’s so intense that it can lead to suicidal thoughts. Having professional psychological support during the withdrawal process can make a big difference. Antidepressants are sometimes prescribed after the acute withdrawal phase has passed if the individual’s depression is deemed clinically significant.
How Long Does Caffeine Withdrawal Last?
We’ll discuss caffeine just briefly since medical or professional intervention isn’t usually necessary. Though completely legal and widely consumed in coffee, tea, and soft drinks, caffeine is a stimulant and some people experience withdrawal symptoms when they stop using it. While you can’t become addicted to caffeine, you can develop tolerance and dependence. Caffeine raises the level of dopamine in the brain but only by a small amount. It’s not enough to affect the brain’s reward circuits.
Anyone who uses caffeine regularly and stops using it abruptly can experience withdrawal symptoms. Symptoms include fatigue, low energy, irritability, headache, anxiety, depressed mood, poor concentration, and tremors. These can last for two to nine days.
Caffeine withdrawal symptoms may seem unbearable but it’s relatively easy to reduce them. You should cut back on your caffeine use gradually over two to three weeks rather than stopping abruptly. Also, drink lots of water, get adequate sleep, and find natural ways to boost your energy.
Why Medical Detox is Important
Detoxification is the process of ridding your body of drugs or alcohol. It happens naturally once you stop drinking or using drugs. However, it’s not always safe to go through the withdrawal process on your own. Most people who want to overcome addiction should undergo medically supervised detox.
This won’t make the process end any faster, but it ensures you’re as safe and comfortable as possible. With 24/7 supervision, you’ll get medical and psychological support when necessary. This support can prevent relapse and improve the likelihood of a successful recovery.
Medical detox is necessary for people addicted to benzodiazepines and alcohol and it is highly recommended for people with other addictions. It’s important to note that detox doesn’t prevent relapse and everyone battling addiction needs to enter a treatment program that includes therapy. Most people benefit significantly from residential treatment followed by outpatient care and long-term support.
You need to get to the bottom of your substance abuse and addiction snd then learn how to avoid triggers and stay sober over the long term. The longer you stay in treatment, the more successful you’re likely to be.
Get Help from Circle of Hope!
If you’re addicted to drugs or alcohol and you want to detox in a safe environment that’s staffed by highly trained professionals, contact Circle of Hope. We’ll provide the support you need during withdrawal and no matter how long the process lasts, we’ll keep you as comfortable as possible while equipping you with the tools to cope. Contact us today!