What are Withdrawal Symptoms of Alcohol, Opiates, Marijuana, Nicotine, Cocaine

Addiction affects a person in more ways than one. Apart from the physical damage, they also cause mental damage. To be simple, imagine the brain to be a spring. A spring compresses and rebounds as per its usage and the load applied. Alcohol and drugs function as brain depressants and figuratively, push the spring down. Hence, the production of neurotransmitters such as norepinephrine also known as noradrenaline is supressed. When the consumption of drugs or alcohol is suddenly stopped, the ‘weight’ of the spring is taken off and this causes the brain to produce adrenalin. In other words, the brain rebounds to regain its normalcy, causing withdrawal symptoms.

There are several factors that make withdrawal symptoms a hazy subject to gauge. While certain drugs like opiates, tranquilizers and alcohol cause physical withdrawal symptoms, others like ecstasy, cocaine and marijuana cause emotional withdrawal symptoms. Another uncertainty is the withdrawal pattern of each person. If a person feels less physical withdrawal symptoms, he/she may feel more emotional withdrawal symptoms than others. The simple truth of the matter is, it is easy to get addicted to anything, but returning to normalcy is tough and slow rewarding.

Lots of changes in a person’s body, behaviour and mood put together are withdrawal symptoms. They manifest themselves when a person stops consuming alcohol or drugs.

While the golden rule is that withdrawal symptoms vary based on the drug used and the person himself, there are a few common withdrawal symptoms:

• Prescription painkillers and heroin cause withdrawal symptoms similar to flu. These symptoms last for 24 hours to 48 hours.
• Cocaine causes withdrawal symptoms restlessness and depression that last for a period of 7 to 10 days.
• Benzodiazepines give withdrawal symptoms such as seizures and anxiety. These withdrawal symptoms last for weeks or, sometimes, even months.
• The withdrawal symptoms of alcohol are tremors and seizures that can last anywhere from three days to several weeks.

There are two predominant types of withdrawal symptoms. The first are emotional withdrawal symptoms caused by all drugs. These are independent of a person having physical withdrawal symptoms. The second are physical withdrawal symptoms that are caused when a person stops consumption of opiates, tranquilizers and alcohol.

Common emotional withdrawal symptoms include:

• Restlessness.
• Anxiety.
• Insomnia.
• Headaches.
• Depression.
• Social isolation.
• Poor concentration.
• Irritability.

Common physical withdrawal symptoms include:

• Palpitation.
• Racing heart.
• Muscle tension.
• Tightness in the chest.
• Difficulty breathing.
• Tremor.
• Nausea, vomiting or diarrhoea.
• Sweating

Tranquilizers and alcohol produce some of the most dangerous physical withdrawal symptoms. Stopping tranquilizers or alcohol suddenly leads to strokes, seizures or even heart attacks in certain high risk patients. Medically supervise detox programs minimize a person’s withdrawal symptoms and cut the risk of some very dangerous outcomes.

Some of the most dangerous withdrawal symptoms are:

• Heart attacks.
• Grand mal seizures.
• Hallucinations.
• Delirium tremens.
• Strokes.

Opiates such as oxycontin and heroin produce some extremely uncomfortable withdrawal symptoms. Heroin withdrawal by itself does not produce strokes, seizures, delirium tremens or heart attacks, but when they are combined with usage of other drugs, the resulting symptoms can be quite dangerous.

The inability to group withdrawal symptoms into a single group is primarily due to the variety of ways with which they interact with bodily functions and the brain. The duration of time for which each drug stays active in one’s body is different. This duration of time (also referred to as the drug’s ‘half-life’) is also responsible for varying withdrawal periods.

Apart from these, there are other factors that influence the occurrence and severity of withdrawal symptoms such as:

• The level to which a person is dependent on the drug.
• Length of time for which a person has been using the drug.
• Type of drug used.
• Method of use (snorting, injecting, swallowing, smoking, etc…)
• Amount consumed each time.
• Medical and mental health.
• Family history.

On a general note, the severity of alcohol withdrawal symptoms depend on the duration for which he or she has been drinking and how much he or she drinks each time. After a person stops drinking, minor symptoms usually occur in 6 to 12 hours’ time. Sometimes, the person still has a measurable level of alcohol in his blood when the symptoms start. Some such withdrawal symptoms are:

• Sweating.
• Mild anxiety.
• Vomiting.
• Insomnia.
• Headache.
• Nausea.
• Hand trembling.

Between 12 and 24 hours after a person stops drinking, he or she may experience auditory, tactile or visual hallucinations. Though this condition is called as alcoholic hallucinosis, they are different from Delirium tremens primarily because most patients are aware of the fact that these sensations are not real. These sensations usually end in 48 hours.

Withdrawal seizures occur between 24 to 48 hours after a person stops drinking. The risk of having seizures is high for patients who have previously undergone multiple detoxification programs.

Delirium tremens (DTs) begin 48 hours to 72 hours after stopping drinking of alcohol. Other risk factors include a history of DTs or withdrawal seizures, abnormal liver function, older age and acute medical illness. DTs produce their own set of symptoms like:

• Confusion, severe anxiety, disorientation.
• Hallucinations those are indistinguishable from reality. These are predominantly visual hallucinations.
• Profuse sweating.
• High blood pressure (B.P).
• Low grade fever.
• Irregular and racing heartbeat.
• Seizures.

These symptoms usually peak at 5 days.

Withdrawal symptoms for opiates depend on the level of withdrawal a person is experiencing. Multiple factors determine the duration for which a person experiences withdrawal symptoms and hence, every patient experiences different withdrawal symptoms. Yet, there is a rough timeline according to which the symptoms progress.

Early symptoms begin in the initial 24 hours after a patient stops using the drug. These withdrawal symptoms are:

• Restlessness.
• Muscle aches.
• Lacrimation.
• Anxiety.
• Runny nose.
• Inability to sleep.
• Frequent yawning.
• Excessive sweating.

Intense withdrawal symptoms that follow after the first day are:

• Diarrhoea.
• Goose bumps on the patient’s skin.
• High B.P (blood pressure).
• Rapid heartbeat.
• Abdominal cramping.
• Dilated pupils.
• Blurry vision.
• Nausea and vomiting.

The withdrawal symptoms associated with opiates are painful and unpleasant. However, these begin to improve within 72 hours and within a week; a person should be able to be back to normal.

Mothers who are addicted to opiates or have used opiates during pregnancy have the risk of passing on the withdrawal symptoms to their babies as well. Babies born to mothers having past or present opiates abuse are reported to suffer from:

• Digestive issues.
• Seizures.
• Dehydration.
• Poor feeding.
• Vomiting.

The most important thing to remember is that different drugs stay in the body for different durations of time, affecting withdrawal onset. The frequency of drug use, severity of the addiction and individual factors such as overall health, etc… are other factors that determine the duration for which a person experiences withdrawal symptoms. A patient is advised to discuss any on-going withdrawal symptoms with his healthcare provider.

As with other drugs, the symptoms of marijuana withdrawal depend on the time span and the frequency for which a person has been using marijuana. Going by common logic, a heavy user will have severe withdrawal symptoms. A patient who has been smoking marijuana for a decade at a high frequency (about thrice a day) will have very severe withdrawal symptoms than someone who smokes marijuana for a few months using it a couple of times per week. The former patient may not be able to cope without marijuana while the latter patient may experience lesser symptoms.

Some common marijuana withdrawal symptoms are

• Anxiety is one of the most common withdrawal symptoms of marijuana. A patient with a history of marijuana abuse feels more anxious in social situations. This is the exact opposite of the ‘relaxed’ feeling observed while smoking marijuana. Simply put, the brain tries to compensate for the chemicals received from smoking marijuana.
• Change in appetite is also a withdrawal symptom. This is completely dependent on the patient in question. Certain patients have reported losing their appetite when under the influence of marijuana while certain others have reported to feel hungrier after smoking marijuana.
• Cramps can be a withdrawal symptom of marijuana. Some patients have reported to suffer from digestion problems and stomach cramps after stopping marijuana use.
• Marijuana craving is the most usual withdrawal symptom. Upon using a drug, it stimulates the brain’s pleasure centre and makes it feel good. When the effect wears out, the brain wants to retain the feeling, resulting in a craving.
• Many people have experienced depression withdrawal symptoms coming off marijuana. This is usually the result of the brain losing its pleasure sensation. Patients tend to feel sad and lose their zest for life.
• Dizziness is a common withdrawal symptom and this is not a fatal symptom and a person is to remain calm till it wears off.
• Depersonalization is also seen in marijuana withdrawal. This is caused due to intense anxiety. Under the influence of drugs, some patients feel like they are not the same person. This is because the brain chemistry of the patient becomes imbalanced resulting in the person becoming instable.
• Mood swings are one of the common withdrawal symptoms of drugs. A person tends to feel alright one minute and depressed/raging anger the next.
• Sweating. Excessive sweating is a withdrawal symptom observed in some patients.
• Sleep disturbances. Patients experience crazy dreams or disrupted sleep. Some patients even wake up at night due to these disturbances.
• Insomnia is another common withdrawal symptom of marijuana. Inability to sleep at night is a major problem for recovering patients. Some suggested methods are to learn relaxation techniques or exercise more during the day so that they are exhausted at night.
• Irritability is also one of the usual withdrawal symptoms of marijuana. Patients tend to experience anger or frustration when they come off the drug. This tends to pass with time.

Marijuana tends to stay in the body for 4 to 21 days from the day of final ingestion. However, there is speculation that even once it has been fully excreted from the body, the patient might experience withdrawal symptoms.

Tranquilizers have their own set of withdrawal symptoms such as:

• Anxiety.
• Aches.
• Pains.
• Feeling of unreality.
• Sleep disturbance.
• Hypersensitivity to light, touch and noise.
• Impaired memory.
• Suicidal thoughts.
• Depression.
• Palpitations.
• Seizures.
• Agoraphobia.

Among active tobacco users, depriving nicotine produces lots of withdrawal symptoms. Some of them are:

• Nausea.
• Constipation or diarrohea.
• Insomnia.
• Fatigue.
• Drowsiness.
• Headaches.
• Irritability.
• Difficulty in concentrating.
• Craving for tobacco.
• Increased desire for sweet taste.
• Increased hunger.
• Depression.

Nicotine withdrawal symptoms peak within two to three days and typically go away in a period of two weeks. This is merely a rough timeline, as some patients have reportedly suffered from nicotine withdrawal for several months.

Primary withdrawal symptoms of cocaine are:

• Restlessness or agitation.
• Depression.
• A feeling of discomfort.
• Fatigue.
• Slowing down of activity.
• Unpleasant and vivid dreams.
• Increased appetite.

Depression and craving can sometimes last for months, especially after stopping long term and heavy usage. In certain cases, withdrawal symptoms have even lead to suicidal thoughts. During withdrawal symptoms, the craving for cocaine becomes powerful and more intense. However, the ‘high’ becomes less and less pleasant in continuous usage giving rise to fear and suspicion. However, the craving for cocaine remains strong.