Addiction or abuse of drugs or alcohol can cause the brain to become reliant on the effects of that substance in the body. When that substance is no longer present, a person may experience significant withdrawal symptoms ranging from emotional distress and anxiety to physical discomfort and pain.

Depending on the given drug or alcohol dependency, withdrawal symptoms can start very soon  after last use or may take weeks to become apparent. A person will then continue battling the effects of withdrawal for anywhere from days to weeks with symptoms progressing and peaking at different points as the substance is gradually flushed from the body.

What is a Drug Withdrawal?

When a person becomes dependent on a specific drug, stopping or dramatically reducing one’s use of the drug can lead to physical, mental, and/or emotional drawbacks known as withdrawals. Over the course of repeated drug use, the brain begins to adapt to the presence and effects of the drug, tricking the body into recognizing it as normal. A physiological dependence on the drug develops as the body becomes increasingly reliant on its effects. Once a person becomes dependent on a drug, a sudden stop or dramatic reduction in use can lead to a variety of withdrawal symptoms as the body attempts to readjust to the lack of its presence and effects.

Drug withdrawal symptoms will vary depending on factors such as:

  • The specific type of drug (ie: opioids, sedatives/benzodiazepines, or stimulants)
  • The person’s level of addiction
  • How much of the drug was used each time
  • Whether the drug was injected, inhaled (via lungs/smoking or nose/snorting), etc.

Other genetic factors such as a person’s physical or psychological state may also impact the severity of withdrawal symptoms. If left unmanaged, certain withdrawal symptoms could be devastating and even life threatening.

Types of Drug Withdrawal

Opioid Withdrawals (Short and Long-Acting)

Opioid addiction has quickly become a serious concern in the United States. Opioids include illegal substances such as heroin, as well as legal prescription painkillers (morphine, hydrocodone, and methadone). According to the CDC, roughly half a million deaths occurred between 1999 and 2019 as a result of opioid misuse and/or overdose.

Common opioids: heroin, morphine, hydrocodone, methadone

How soon after last use do opioid withdrawal symptoms begin?

  • With short-acting opioids like heroin, symptoms typically begin 6-12 hours after last use of the drug and are at their worst at about 36-72 hours.
  • Longer-acting opioids such as methadone may take up to 2 days for withdrawal symptoms to begin and often peak around 3 days.

How long do opioid withdrawal symptoms last?

  • Withdrawal symptoms from short-acting opioids can last up to 5-10 days.
  • Withdrawal symptoms from long-acting opioids can last much longer, up to 3 weeks.

Symptoms of opioid withdrawal include:

  • Excessive sweating
  • Runny nose and watery eyes
  • Nausea, diarrhea, and vomiting (which can lead to dehydration)
  • Chills or cold flashes accompanied by goosebumps
  • Muscle spasms
  • Pain of the muscles, bones, or joints
  • Elevated heart rate
  • Trouble breathing
  • Difficulty sleeping or insomnia
  • Increased irritability
  • Mood swings
  • Depression
  • Anxiety
  • Paranoia
  • Apathy
  • Severe drug cravings

Sedative/Benzodiazepine Withdrawals

Sedatives or benzodiazepines (also referred to as “benzos”) are drugs used to calm or sedate a person. These drugs are often used for treating anxiety, insomnia, or seizures, and may be prescribed for depression, general anesthesia, or alcohol withdrawal symptoms. However, misuse or abuse of benzos can cause the brain to become dependent on the drugs’ effects and will often lead to withdrawals when stopping use.

Common sedatives/benzos: diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax)

How soon after last use do sedative withdrawal symptoms begin?

  • Withdrawal symptoms associated with short-acting sedatives (such as Ativan) can begin within just hours of last use and peak at about the second day.
  • Longer-acting sedatives (such as Valium) may take up to a week for withdrawal symptoms to begin and peaks during the second week.

How long do sedative withdrawal symptoms last?

  • Withdrawals from short-acting sedatives typically last about 4-5 days
  • Long-acting sedative withdrawals can take over a month to fully resolve

Symptoms of sedative withdrawals include:

  • Upset stomach and gastrointestinal distress or discomfort
  • Increased heart rate and/or blood pressure
  • Excessive sweating
  • Fever
  • Heightened anxiety
  • Panic attacks
  • Difficulty sleeping or insomnia
  • Loss of appetite
  • Diarrhea
  • Hallucinations
  • Seizures

Stimulant Withdrawals

Opposite of sedatives, stimulant drugs such as cocaine, methamphetamines, and amphetamines are substances that raise the body’s level of physiological and nervous activity. These drugs are often highly addictive because of their initial effects, however, prolonged or excessive use can lead to adverse side effects and withdrawals. 

Common stimulants: cocaine, meth, nicotine, Adderall

How soon after last use do stimulant withdrawal symptoms begin?

  • Stimulant withdrawals typically begin within the first 24 hours of last use.

How long do stimulant withdrawal symptoms last?

  • Symptoms of stimulant withdrawals can last for up to 5 days depending on the severity of the drug dependency.

Symptoms of stimulant withdrawals include:

  • Physical exhaustion or lethargy
  • Increased desire for sleep
  • Increased appetite
  • Moodiness
  • Irritability

What is Alcohol Withdrawal?

When a person is addicted to alcohol (beer or liquor), their body often becomes reliant on the numbing effects of the substance. Overconsumption of alcohol can lead to problems with both physical and mental health, and may also negatively impact a person’s social life or relationships. For many, going sober is key to overcoming alcohol dependency. When stopping consumption of alcohol after long periods of excessive use, withdrawal symptoms will often follow.

How soon after drinking do alcohol withdrawal symptoms begin?

  • Initial alcohol withdrawal symptoms typically start at about 8 hours after last consumption. Symptoms are generally at their worst at about 72 hours.

How long do alcohol withdrawal symptoms last?

  • Alcohol withdrawal symptoms can last for up to a full week.

Symptoms of alcohol withdrawal include:

  • Heightened anxiety
  • Abdominal pain or discomfort
  • High blood pressure
  • Increased heart rate
  • Fever
  • Confusion
  • Hallucinations
  • Seizures
  • Irritability
  • Excessive sweating
  • Difficulty sleeping
  • Nausea and vomiting

Overcoming Drug and Alcohol Withdrawals

While withdrawals can be extremely troublesome and discouraging, it’s important to realize that these symptoms are temporary. With proper care and management, a person can overcome withdrawal symptoms and start their life free of a crippling reliance on drugs or alcohol.