Withdrawal symptoms and length vary widely from substance to substance, as well as from person to person. The following is a list of what the detox process might look like for some commonly abused substances.
Withdrawal from alcohol can begin as soon as a few hours after the last drink and can last from 7 to 10 days—although cases lasting a few weeks have been reported.
Symptoms of alcohol withdrawal include anxiety, shaking, headaches, seizures, and delirium tremens (or DTs) which can cause confusion, hallucinations, rapid heartbeat, and fever. Death is possible in severe cases.
Since alcohol withdrawal is so dangerous, inpatient detox and medical supervision are essential. Treatment with medication will reduce or eliminate most symptoms. After detox, inpatient treatment is recommended.
Withdrawal from benzos begins when the last dose has worn off, which varies depending on the specific benzo taken (Xanax is shorter acting than Valium or Klonopin). Symptoms can last for weeks, or even months, with post-acute withdrawal syndrome (PAWS) lasting for a year or more.
Benzo withdrawal symptoms include anxiety, depression, pain, “brain zaps,” fatigue, and insomnia. In cases of severe dependence, or abrupt discontinuation, confusion, seizures, coma, DTs (similar to alcohol) or even death may occur. Post-acute symptoms can include anxiety and depression.
With benzos being another dangerous drug to withdraw from, medical treatment is absolutely necessary, at least for the early stages. Patients must be stabilized, with the correct medication and care, before they can safely be released. Inpatient treatment is recommended.
Heroin withdrawal begins 6-12 hours after the last dose, peaks after 1-3 days, and usually subsides within a week.
Depending on the severity of the addiction, heroin withdrawal symptoms can range from nausea, cramps, runny nose, yawning and tearing, to sweats, chills, severe aches, vomiting, diarrhea, fatigue, insomnia, depression or suicidal thoughts, and restless legs. These are usually accompanied by drug cravings.
While withdrawal itself is not fatal, it is still recommended to seek detox for heroin withdrawal followed by inpatient treatment. Treatment and medication make the process more comfortable and reduce the risk of relapse or suicide.
Painkillers and Other Opiates
Similar to heroin, withdrawal from opiates usually begins within 12 hours (but this can take longer in the case of methadone and buprenorphine (Suboxone). It is usually over within a week, but methadone and buprenorphine can take up to a month.
Symptoms of withdrawal are the same as heroin: they can range from nausea, cramps, runny nose, yawning and tearing to sweats, chills, severe aches, vomiting, diarrhea, fatigue, insomnia, depression or suicidal thoughts, and restless legs. These are usually accompanied by drug cravings.
As with heroin, it is recommended to seek detox for opiate withdrawal followed by inpatient treatment. This will make the process easier and reduce the risk of anything bad happening.
Users experience a “crash” within hours after stopping a cocaine binge. Some withdrawal symptoms may be felt for the next few days, although mild symptoms can persist for weeks or months.
Crash and withdrawal symptoms include depression, fatigue, strong appetite, and difficulty concentrating. Cravings and lethargy can occur for some time after withdrawal has ended.
Medical detox from cocaine is not usually necessary, but may be helpful, and inpatient treatment is highly recommended to get the patient stable and to reduce risk of relapse.
Amphetamine / Methamphetamine / Prescription Stimulants
As with cocaine, the crash and withdrawal from stimulants begins hours after the last dose. Symptoms can last for up to two weeks.
Users often experience depression, fatigue, strong appetite, anxiety, irritability, and slow reactions. Symptoms like cravings and lethargy can continue for much longer after acute withdrawal.
Medical treatment may help but is not required. Considering risk of relapse, inpatient treatment is highly recommended after detox to give the user a foundation on which to base their sobriety.
Contrary to what many believe, heavy marijuana use can cause withdrawal. Symptoms usually begin within a day of the last dose and can last months.
Typical withdrawal symptoms include insomnia, lack of appetite, nausea, vivid dreams, irritability, anxiety, depression and sweating.
Detox is generally not necessary for marijuana. Inpatient treatment is recommended for marijuana addicts to get them through the majority of withdrawal symptoms, reduce the risk of relapse, and give them the tools they need to stay sober.