Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Drug Withdrawal

(Abstinence Syndrome)
by Patricia Griffin Kellicker, BSN
Definition

Drug withdrawal is a reaction the body can have if a person suddenly stops using drugs or alcohol. This can occur if the person has been using drugs or alcohol regularly. Depending on the type and amount, withdrawal can be a life-threatening condition. The sooner it is treated, the better the outcome. If you think you have this condition, call your doctor right away.

Causes

Drug withdrawal can be caused by medicines, alcohol, or illegal drugs. Some things that can cause withdrawal include:

  • Alcohol
  • Amphetamines
  • Barbiturates
  • Benzodiazepines
  • Cocaine
  • Heroin
  • Marijuana
  • Methadone
  • Opioids
Risk Factors

These factors increase your chances of developing this condition. Tell your doctor if you have any of these risk factors:

  • Sudden stopping of drugs or alcohol
  • Physical dependency on drugs or alcohol
  • Substance abuse
Symptoms

Withdrawal symptoms are different based on what you used. Symptoms may include:

  • Alcohol—shaking, hallucinations, seizures, confusion, anxiety , sweating, nausea
  • Cocaine—anxiety, feeling tired, depression
  • Opioids—abdominal pain or cramps, muscle aches, panic, tremors, sweating, nausea, diarrhea , fever, chills, irritability, goose pimples, runny nose, drug craving, inability to sleep, yawning
  • Amphetamines—depression, irritability, sleeping too much, muscle aches, abdominal pain
  • Barbiturates—weakness, tremors, hallucinations, lack of appetite, seizures
  • Benzodiazepines—abdominal pain or cramps, fast heartbeat, vomiting, tremors, seizures, anxiety
  • Marijuana—loss of appetite, chills, weight loss, trouble sleeping or sleeping too much, irritability, feeling restless or nervous

Diagnosis

Your doctor will ask about your symptoms. She will take a medical history and do a physical exam. You will be asked which drugs you used, how often, how much, and for how long. You may also have blood and urine tests.

Treatment

Talk with your doctor about the best treatment plan for you . Treatment options include the following:

Detoxification

This is the first step in treating substance abuse. You will be closely checked for signs of withdrawal. You may be given medicines to reduce cravings. These medicines will also help with symptoms. Withdrawal symptoms can be severe. Treatment is targeted to the specific symptoms and drugs used.

Rehabilitation

You may need to enroll in a rehabilitation program. This treatment uses behavioral therapy to prevent you from using drugs in the future. Behavioral therapy may include the following:

  • Cognitive behavioral therapy teaches you how to recognize and avoid situations that may lead to drug abuse.
  • Family therapy helps you and your family look at patterns of drug abuse. Strategies are suggested to avoid future abuse.
  • Motivational therapy uses positive reinforcement to prevent drug use.
Residential Treatment (Therapeutic Communities)

Residential treatment is sometimes needed. The typical stay is 6-12 months. These facilities will help you learn how to live a drug-free life.

Support Groups

Support groups offer continued support for a drug- or alcohol-free life. Some support groups are Narcotics Anonymous, Cocaine Anonymous, and Alcoholics Anonymous.

Prevention

To help reduce your chances of developing drug withdrawal, take the following steps:

  • Attend regular support group meetings.
  • Avoid people and situations where drugs are available.
  • Inform all healthcare providers of your history with drugs.

Last reviewed: December 2010 by Rosalyn Carson-Dewitt, MD.

RESOURCES:
CANADIAN RESOURCES:
References:
  • An approach to drug abuse, intoxication, and withdrawal. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000501/2763.html . Accessed September 9, 2009.
  • Buprenorphine: an alternative to methadone. Med Lett Drugs Ther . 2003; 45:13.
  • Kosten TR, O'Connor PG. Management of drug and alcohol withdrawal. N Engl J Med . 2003; 348:1786.
  • Narcotic drug withdrawal. University of Michigan Health System website. Available at: http://www.med.umich.edu/1libr/aha/aha_subabu_bha.htm . Accessed September 9, 2009.
  • NIDA infofacts: treatment approaches for drug addiction. National Institute for Drug Abuse website. Available at: http://www.nida.nih.gov/Infofacts/TreatMeth.html . Accessed September 9, 2009.
  • O'Connor, PG. Methods of detoxification and their role in treating patients with opioid dependence. JAMA . 2005; 294:961.
  • Opiate withdrawal. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 18, 2009. Accessed September 9, 2009.
  • Principles of drug addiction treatment: a research based guide. National Institute of Drug Abuse website. Available at: http://www.nida.nih.gov/PODAT/PODATIndex.html . Accessed September 9, 2009.
  • Professional Guide to Diseases . 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.