The fear of painful withdrawals acts as one of the major barriers to recovery for people suffering with substance use disorder. Many people in active addiction don’t even feel that they are getting drunk/high anymore when using substances. They simply use them to maintain homeostasis and prevent themselves from getting sick. Their body has come to rely on the presence of the drug in their system and may present unpleasant and painful side effects when withdrawing. Some withdrawal symptoms can be fatal, such as in the case of alcohol and benzodiazepines (Xanax, Valium, etc). The severity of drug alcohol withdrawal symptoms vary depending on many factors. These include how long the person has been using the drug, the amount they are using, the type they are using, and that individual’s age, height, weight, and their unique genetics.
How long do withdrawals last for drugs and alcohol?
The timeline for drug and alcohol withdrawals varies by substance. Some do not have significant withdrawal symptoms at all, while others can take 7-10 days. There are also long term symptoms of stopping drug and alcohol use such as post-acute withdrawal syndrome (PAWS). PAWS does not manifest until approximately 60-90 days after a person stops drinking.
The withdrawal process becomes significantly more comfortable and safe when done in a clinically supervised detox facility. Acute detox centers offer prescription medication, catered meals, and housekeeping. By having basic necessities taken care of, the person detoxing can relax and focus on staying comfortable. Our licensed mental health counselors can provide more specific information on what to expect with free case assessments over the phone: 855-997-4702
What are drug alcohol withdrawal symptoms?
Symptoms vary depending on the specific substance:
Alcohol detox is one of the most dangerous. Withdrawal symptoms such as tremors can begin between 5-10 hours after the last drink, but delirium tremens (“the DTs”) can set in from 24-72 hours after the last drink. DTs can include seizures, hallucinations, dehydration, hypertension, and reduced blood flow to the brain. According to Harvard Medical School, the DTs only happen to about 5% of people who go through alcohol withdrawal, but can kill up to 1 in 20 people who develop it.
Opioid Detox (Fentanyl, Heroin, Oxycodone, Prescription Painkillers)
Opioid withdrawals can start a few hours after the last dose. Known as getting “dopesick,” opioid withdrawals have a reputation for getting very uncomfortable. The withdrawal symptoms tend to peak within 72 hours. But they can continue on an acute basis for 2-3 weeks. Many people in recovery for opioid use disorder continue with maintenance medication to avoid relapse. This is known as medication-assisted treatment (MAT) and usually consists of some combination of buprenorphine and/or naltrexone. These are available in sublingual film, pill, or monthly injection form.
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Benzodiazepines (Including Sleeping Pills, Anti-Anxiety meds)
Benzos, like alcohol, are a potentially dangerous substance to detox from. Withdrawals from benzos usually begin about eight hours after the last dose. It is medically necessary to taper from benzos in a physician-assisted environment such as a clinical detox facility.
Is it safe to go cold turkey, or is medically supervised detox necessary?
The safety of withdrawals depends on the substance, dose, and individual. Drug and alcohol withdrawal is a highly individualized phenomenon. What may be safe for one person may not be safe for another, and some substances are not safe to quit cold turkey under any circumstances. But no matter what substance, detox can help any person going through withdrawals be more safe and comfortable during the experience.
Detox centers offer services such as detox medication, catered meals, housekeeping, and an introduction to recovery. Intensive programming is reserved for after detox when individuals are more clear and focused. But individuals can get on the right track by detoxing in a supervised environment where relapse is not possible.
What does the process look like for going to rehab? What happens after detox?
Rehab includes a continuum of care that ideally includes detox, residential, intensive outpatient care, and aftercare. All of these steps exist for important and distinct reasons since recovery has phases. For example, the mind is not particularly clear or sharp during the detox phase as the body is getting stabilized to not having drugs actively present in the system. After that, residential provides a safe environment where individuals can focus on therapy and meetings without the risk of relapse. At this stage, outpatient is not recommended because relapse risk is highest during the first 90 days of treatment.
After residential treatment is over (typically 30-90 days, but can last up to a year), outpatient helps individuals transition to an independent life. At this point, the person has enough clean time under their belt and fresh programming to remember the right things to do in order to avoid relapse. It is suggested that individuals get an AA/NA sponsor sometime between inpatient and intensive outpatient (IOP). Sponsors help walk individuals through the 12 steps and ensure they are done thoroughly. They also provide accountability and structure.
Many individuals also benefit from sober living during and/or after intensive outpatient. Sober living adds another layer of security and accountability. These facilities will regularly drug test and breathalyze residents, and they provide a drug and alcohol-free home environment. Many individuals find it helpful to reside in a sober living facility for a few years after treatment just to ensure they stay on the right track. Relapse happens at a higher rate during early sobriety, with much lower rates after 1-5 years of continuous sobriety.
If you or someone you love needs detox, our addiction counselors are available 24/7 by phone for free case assessments: 855-997-4702