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Drug and Alcohol Withdrawal

(Abstinence Syndrome)

Definition

Drug withdrawal is a reaction the body can have if a person suddenly stops using illegal drugs, prescription medications, or alcohol. This can occur if the person has been using drugs, medications, or alcohol regularly. Depending on the type and amount of the substance you were using, withdrawal can be a life-threatening condition.

Causes    TOP

Drug withdrawal can be caused by illegal drugs, prescription medications, or alcohol.

Risk Factors    TOP

Factors that increase your chances of drug withdrawal include:

  • Sudden stopping of illegal drugs, prescription medications, or alcohol
  • Substance abuse
  • Psychological dependence and addiction

Symptoms    TOP

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

  • Marijuana—loss of appetite, chills, weight loss, trouble sleeping or sleeping too much, irritability, feeling restless or nervous
  • Alcohol—shaking, hallucinations, seizures, confusion, anxiety, sweating, nausea
  • Barbiturates—weakness, tremors, hallucinations, lack of appetite, seizures
  • 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
  • Benzodiazepines—abdominal pain or cramps, fast heartbeat, vomiting, tremors, seizures, anxiety
  • Cocaine—anxiety, feeling tired, depression
  • Amphetamines—depression, irritability, sleeping too much, muscle aches, abdominal pain

Anxiety

Physical reaction anxiety
Anxiety is a symptom of drug withdrawal from substances like cocaine and alcohol.
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Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. Your bodily fluids may be tested. This can be done through blood and urine tests.

Treatment    TOP

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

Detoxification

This is the first step in treating abuse. You will be closely checked for signs of withdrawal. You may be given medications to reduce cravings. Medications will also help to reduce withdrawal symptoms, which 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)    TOP

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    TOP

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

Prevention    TOP

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.

RESOURCES:

National Institute on Drug Abuse
http://www.nida.nih.gov
Substance Abuse & Mental Health Services Administration
http://www.samhsa.gov

CANADIAN RESOURCES:

Centre for Addiction and Mental Health
http://www.camh.net
Narcotics Anonymous
http://www.torontona.org

References:

Buprenorphine: an alternative to methadone. Med Lett Drugs Ther. 2003; 45:13.
Drugs, brains, and behavior. The science of addiction National Institute for Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface. Updated July 2014. Accessed June 21, 2016.
Drugfacts: Treatment approaches for drug addiction. National Institute for Drug Abuse website. Available at:
...(Click grey area to select URL)
Updated January 2016. Accessed June 21, 2016.
Giannini AJ. An approach to drug abuse, intoxication, and withdrawal. Am Fam Physician. 2000;61(9):2763-2774.
Kosten TR, O'Connor PG. Management of drug and alcohol withdrawal. N Engl J Med. 2003; 348:1786.
O'Connor, PG. Methods of detoxification and their role in treating patients with opioid dependence. JAMA. 2005; 294:961.
Opioid withdrawal. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115893/Opioid-withdrawal. Updated April 17, 2014. Accessed June 21, 2016.
Principles of drug addiction treatment: a research based guide. National Institute of Drug Abuse website. Available at:
...(Click grey area to select URL)
Updated December 2012. Accessed June 21, 2016.
Last reviewed June 2016 by Marcin Chwistek, MD
Last Updated: 5/28/2015

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