Withdrawal Explained

Medically Reviewed By Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
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Withdrawal happens when you cut off or cut back on the use of addictive substances, such as alcohol, nicotine, caffeine, and cannabis. This article will define what withdrawal is. It will also discuss the symptoms, causes, and treatments of certain types of withdrawal.

What is withdrawal?

Male sitting on bed with his hands on his head, looking distressed or worried
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Withdrawal is the process your body goes through when you cut off or cut back on addictive substances, such as alcohol and nicotine.

Addiction is a dependence on a specific type of substance. There are two types of addiction, physical and psychological. You can have either type or both at the same time.

Physical addiction is when you experience withdrawal symptoms when you stop using the addictive substance. However, psychological addiction is when you believe you need that substance to function.

There are many substances the body can develop an addiction to and experience withdrawal symptoms when a person stops using them. Some of the most common among these are:

If you are experiencing withdrawal, contact your doctor. They may be able to help you manage your symptoms.

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What are the symptoms of withdrawal?

Some symptoms of withdrawal will overlap. However, typically they will depend on the substances you are experiencing withdrawal from.

Alcohol withdrawal

The symptoms of alcohol withdrawal range from mild to severe. They typically reach their worst within the first 48 hours of the last time you drank alcohol. It generally takes 3–7 days for your body to overcome the withdrawal and the symptoms to ease.

Symptoms of alcohol withdrawal include:

Severe symptoms that may cause complications include:

If you are experiencing symptoms of alcohol withdrawal, contact your doctor.

Nicotine withdrawal

The experience of trying to quit smoking is different for everyone. Many people will have some symptoms of withdrawal during the process. Symptoms of nicotine withdrawal are typically highly uncomfortable. However, they generally are not harmful.

The nicotine withdrawal symptoms typically fade over time as you remain smoke-free and your body adjusts to not having nicotine.

The symptoms of withdrawal include:

  • feeling cravings and urges to smoke
  • feeling irritable or upset
  • feeling jumpy and restless
  • having difficulty concentrating
  • having difficulty sleeping
  • feeling hungrier than usual
  • gaining weight
  • feelings of anxiety, sadness, or depression

Cannabis withdrawal

Around 30% of people who use cannabis regularly have some form of cannabis use disorder. Experts associate this use disorder with cannabis dependence. Dependence can turn into addiction if you cannot stop using the substance once it begins to negatively affect your daily life.

The Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5) recently added cannabis withdrawal syndrome (CWS). To receive a diagnosis of CWS you must first display 3 or more of the following symptoms. The symptoms typically occur less than 1 week after stopping the use of cannabis.

These symptoms include:

  • irritability
  • nervousness or anxiety
  • difficulty sleeping
  • decreased appetite or weight loss
  • depressed mood
  • one or more of these physical symptoms:

The severity and duration of your withdrawal symptoms depend on the frequency of use, the severity of the dependence, life stressors, and past experiences.

Caffeine withdrawal

Caffeine is one of the most widely used stimulants in the world. In most areas, it is legal, inexpensive, and unregulated. Since many people habitually drink caffeine beverages, it can often lead to physical, emotional, and psychological dependence. This dependence can result in withdrawal symptoms after a sudden stop in caffeine intake.

Typically the onset of caffeine withdrawal symptoms happens within 12–24 hours after you stop drinking caffeine. They generally peak at 20–51 hours and may last anywhere between 2–9 days.

The symptoms will vary from person to person and range from mild to severe. Symptoms of caffeine withdrawal include:

  • headache
  • fatigue and drowsiness
  • decreased energy and alertness
  • depressed mood
  • difficult concentrating
  • irritability
  • feeling foggy-headed

To read about substance use disorders, click here.

What causes withdrawal?

Your body is always working to maintain balance among its systems. When you remove a substance your body has become dependent on, it reacts by trying to offset the changes happening. This leads to withdrawal symptoms.

For instance, when you quit smoking, your body and brain have to adjust to living without nicotine. This is why you feel withdrawal symptoms, such as cravings and irritability. Your body is working harder than usual to regain a sense of balance while adjusting to not having that substance anymore.

How do you treat withdrawal?

Treatment for withdrawal depends on the severity of your symptoms and what substance you are experiencing withdrawal from. Withdrawal symptoms from substances such as nicotine and caffeine will generally dissipate on their own over time.

Contact your doctor if you experience more severe withdrawal symptoms. They can help provide treatment options. The most severe symptoms may require treatment in a rehabilitation facility. These facilities can provide constant care in case the symptoms worsen suddenly.

Typical treatment for more severe withdrawal symptoms includes:

  • IV rehydration, administered through a vein
  • correction of electrolyte imbalances
  • medications, such as benzodiazepines
  • inpatient or outpatient supportive therapy

What are ways to cope with withdrawal?

If you are experiencing withdrawal from alcohol, contact your doctor for help with managing the symptoms. There are ways to help you cope with the symptoms of milder withdrawal symptoms, such as:

  • Avoid places or habits that may trigger a craving.
  • When you feel irritable, take a few deep breaths and remind yourself why you are quitting.
  • Maintain a nutritious diet to help manage weight gain.
  • Exercise regularly to help with weight gain and manage the feelings of restlessness.
  • Limit your intake of caffeine to help with any sleep difficulties.

Speak with your doctor about medications that can help with the process of quitting smoking.

Remember not to be too hard on yourself. Your body is working very hard to adjust to the absence of a substance it has become dependent on.

Help for substance use disorder is available

Seeking help for addiction may seem daunting and possibly even scary. However, several organizations can provide support.

If you believe that you or someone close to you is experiencing addiction, you can contact any of the following organizations for help and advice:

Summary

Withdrawal happens when you stop using a substance you are dependent on. These substances can include alcohol, nicotine, cannabis, and caffeine.

Symptoms of withdrawal vary from person to person and depend on what substance you are experiencing withdrawal from.

If you are experiencing severe withdrawal symptoms or have concerns about dependency, contact your doctor.

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Medical Reviewer: Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
Last Review Date: 2022 May 31
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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