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Preparing for Withdrawal and Detox

Hannah Friedman
 May 5th, 2022|   Clinically Reviewed by 
Lisa Misquith

When you begin healing from addiction, it’s natural to be concerned about withdrawal. This process can be uncomfortable or even dangerous without proper supervision. But no matter how long you’ve been misusing substances, healing is always possible. And there are many well-established approaches to treatment for drug and alcohol withdrawal.

Before you begin any new process—especially a medical one—it’s best to learn about what to expect. But because everyone’s body is different, everyone’s experience of withdrawal will be unique. Make sure you talk to a doctor who knows your health history before committing to any form of treatment.

What Happens During Withdrawal?

Withdrawal occurs when you stop taking a substance after a prolonged period of use. According to The American Society of Addiction Medicine, withdrawal can be defined as the onset of certain “signs and symptoms following the abrupt discontinuation of, or rapid decrease in, dosage of a psychoactive substance.”

Common Withdrawal Symptoms

These signs may vary depending on the state of your physical and mental health, which specific substances you’ve been using, and how quickly you taper off your use. However, there are a few especially common symptoms of withdrawal and detox,1 which include the following:

  • anxiety
  • depression
  • tremors
  • trouble sleeping
  • nausea, vomiting, and changes in appetite
  • changes in blood pressure and heart rate

In part, these symptoms are caused by the way the body adapts to habitual substance misuse. As you become accustomed to the effects of a drug, you may rely on it to make you feel a certain way. If you drink coffee every morning for years, you’ll probably be tired on days when you don’t. And if you take Xanax several times a day, you’ll probably be anxious when you stop.

Physical vs. Psychological Dependence

While some addictions are physiological, others are primarily psychological. The National Institute on Drug Abuse (NIDA) characterizes addiction as the “inability to stop using a drug,” despite its negative consequences. Addiction is distinct from physical dependence,2 in which your body comes to rely on a drug for certain functions. You can become physically dependent on any substance, from heroin to insulin.

Withdrawal from certain substances—such as opiates, alcohol, and benzodiazepines—can have much more serious side effects, and may even be life-threatening. If you have a history of addiction to any of these drugs, it’s extremely important to seek medical advice, instead of trying to detox on your own.

Withdrawal can be an intense experience whether or not you’re physically dependent on a drug. And because of this, many people delay starting detox. If abstinence is your ultimate goal, however, withdrawal is a necessary step toward recovery. And with the proper care, this experience lasts only a short time.

How Long Does Withdrawal Last?

The recommended length of detox treatment3 depends on a number of factors. First and foremost, the withdrawal period varies between substances. And it can even vary within a single drug class. According to experts at the Substance Abuse and Mental Health Services Administration (SAMHSA), this is clearly seen among opiate users. Specifically, “heroin withdrawal typically begins 8 to 12 hours after the last heroin dose and subsides within a period of 3 to 5 days. Methadone withdrawal typically begins 36 to 48 hours after the last dose, peaks after about 3 days, and gradually subsides over a period of 3 weeks or longer.”

Your physical health may also affect the length of withdrawal. If you take prescribed medications that interact with drugs of abuse, those prescriptions may need to change when you begin recovery. This is an especially important consideration for patients with a history of abusing prescription drugs, like painkillers and benzodiazepines. After your withdrawal symptoms subside, you may find that other symptoms have returned. In order to manage these concerns, it’s important to work with a medical team throughout the process.

Planning Ahead for Recovery

Recovery might begin with detox, but it doesn’t end there. After your withdrawal symptoms subside, it’s best to continue treatment either in a residential or outpatient setting. Some inpatient rehabs also host on-site detox programs, so you can stay on the same campus when it’s time to start a new form of treatment. Other centers only offer detox services, but may ask that you make arrangements for longer-term care before you arrive.

To find a rehab that can help you navigate withdrawal symptoms, you can browse our list of detox centers here.

Reviewed by Lisa Misquith

  1. Detox. (2018, November 8). Recovery Research Institute. https://www.recoveryanswers.org/resource/alcohol-and-drug-detox/ []
  2. Szalavitz, Maia, et al. “Drug Dependence Is Not Addiction—and It Matters.” Annals of Medicine, vol. 53, no. 1, pp. 1989–92. PubMed Central, https://doi.org/10.1080/07853890.2021.1995623. Accessed 6 Feb. 2023. []
  3. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006. Retrieved from https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf []

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