Withdrawal Symptoms: What to Expect and When to Seek Help
Withdrawal from alcohol, opiates, or benzodiazepines can be life-threatening. If you or someone near you is experiencing tremors, seizures, hallucinations, or confusion, call Changes Rehab on 081-444-7000 for immediate medical assessment.
Withdrawal from alcohol, opiates or benzodiazepines can be life-threatening. If you or someone near you is experiencing tremors, seizures, hallucinations or confusion, call Changes Rehab on 081 444 7000 for immediate medical assessment.
Why Withdrawal Management and Detox Matter
Withdrawal is what happens when a body that has adapted to a substance suddenly goes without it. Symptoms range from muscular tension, irritability and broken sleep at the mild end, through to seizures and delirium at the severe end, depending on the substance and how long it has been used.
Managing that safely matters because alcohol, benzodiazepine and GHB withdrawal can kill. Detox is the medical step that keeps someone stable long enough to start treatment.
What Is Drug Withdrawal?
Withdrawal happens when your body has adapted to regular substance use and the substance is suddenly reduced or stopped. The severity of withdrawal symptoms depends primarily on the substance, the quantity used and how long you have been using it.
Withdrawal falls into three main categories: depressant withdrawal (alcohol, benzodiazepines), opioid withdrawal (heroin, codeine, methadone) and stimulant withdrawal (methamphetamine, cocaine).
Withdrawal from heroin and alcohol can be severe and, in some cases, life-threatening. Medically managed detox can mean the difference between a safe recovery and a medical emergency.
Other drugs where proper detox can be life-saving include:
- benzodiazepines (prescription anti-anxiety medication)
- GHB (a designer club drug)
- codeine (a legally available opiate commonly found in cough mixtures and pain medication)
Signs and Symptoms of Alcohol Withdrawal
A person who drinks high volumes of alcohol for weeks, months or years is at risk of experiencing withdrawal symptoms. Someone who only drinks occasionally is unlikely to experience them.
Anyone who has suffered alcohol withdrawal symptoms in the past is much more likely to experience them again when they stop drinking. Withdrawal is caused by the way the brain adapts to regular high volumes of alcohol. When the alcohol is removed, the brain carries on in that keyed-up state, which is what produces the symptoms.
Alcohol withdrawal symptoms sit on a wide spectrum. Milder symptoms such as anxiety, tremor, nausea and disturbed sleep often begin within hours of the last drink. At the severe end, some drinkers develop seizures or delirium tremens, which are dangerous and need urgent medical care.
How quickly and how severely symptoms appear depends on how much and how long a person has been drinking.
Timeline of Alcohol Withdrawal Symptoms
| Time since last drink | What happens | Risk level |
|---|---|---|
| 6 to 12 hours | Anxiety, tremor, headache, nausea, sweating, broken sleep | Mild to moderate |
| 12 to 24 hours | Hallucinations begin in some people, usually visual or tactile | Serious |
| 24 to 48 hours | Highest-risk window for withdrawal seizures | Dangerous |
| 48 to 72 hours | Delirium tremens can develop: confusion, fever, racing heart | Life-threatening |
| 3 to 7 days | Symptoms settle for most people, DTs can persist without treatment | Needs monitoring |
DTs occur in roughly 5% of people experiencing alcohol withdrawal, but the condition kills 1 in 20 people who develop it, according to Harvard Medical School.
Anyone experiencing alcohol withdrawal, or planning to quit heavy drinking abruptly, needs medical attention immediately. Make sure they are admitted to a medical detox programme.
In the vast majority of cases properly managed detox for alcohol prevents serious withdrawal symptoms. Preventing uncomfortable and dangerous withdrawal symptoms also increases the chances of a sustained recovery and long-term abstinence from alcohol.
Delirium Tremens Symptoms and Seizure Risk
Delirium tremens, often shortened to DTs, is the most severe form of alcohol withdrawal. It affects roughly 5% of people who withdraw from heavy drinking, and it is a medical emergency that can be fatal without treatment.
Delirium tremens symptoms usually appear 48 to 72 hours after the last drink, once milder withdrawal has already set in. The timeline table above shows where DTs sit in relation to the earlier stages.
The signs of delirium tremens itself are severe and include:
- Deep confusion and disorientation
- Agitation and vivid hallucinations
- Drenching sweats and fever
- A fast or irregular heartbeat with rising blood pressure
Withdrawal seizures are a separate danger and tend to strike earlier, often within the first 24 to 48 hours. The risk rises with each previous episode of withdrawal, so someone who has detoxed and relapsed several times faces a higher chance of seizing.
This is why heavy drinkers should never detox alone or stop suddenly at home. Medically supervised detox provides the monitoring and medication, usually benzodiazepines, that prevent seizures and delirium tremens from becoming deadly.
At Changes Rehab, every high-risk alcohol withdrawal is managed in medically supervised detox, where a clinical team can act the moment symptoms escalate.
Signs and Symptoms of Heroin or Opiate Withdrawal
Withdrawal from heroin or other opiates such as codeine rarely threatens life. It is severely uncomfortable and hard to withstand without treatment.
Providing withdrawal management in a way that reduces discomfort and shows empathy helps build trust between patients and treatment staff, which increases the likelihood of long-term successful rehabilitation.
Detox for opiates consists of care and medication aimed at combatting each symptom.
Symptoms of Opiate Withdrawal in the First 24 Hours
- Nausea and vomiting
- Anxiety
- Insomnia
- Hot and cold flushes
- Sweating
- Muscle cramps
- Watery discharge from eyes and nose
- Diarrhoea
Signs and Symptoms of Withdrawal From Sedatives (Benzodiazepines)
More and more people are seeking treatment for prescription drugs, and sedatives are among the most common prescription drugs of abuse. Benzodiazepine withdrawal can be life-threatening.
Common sedatives in this class are Valium and Xanax. Doctors usually take a person off these drugs slowly, tapering the dose using the same drug or a different sedative.
Do not quit these drugs cold turkey or try to taper them yourself. Medical professionals are needed to regularly check heart function and breathing during withdrawal from benzodiazepines.
Symptoms of Withdrawal From Benzodiazepines in the First 4 Days
- Delirium or detachment from reality
- Muscle spasms
- Anxiety
- Depression
- Aches and pains
- Abnormal body sensations
- Insomnia
- Nausea
- Seizures
Never stop benzodiazepines without medical supervision.
Duration of Withdrawal for Common Drugs
The duration of withdrawal symptoms varies by substance:
- Alcohol: 5 to 7 days
- Benzodiazepines: 1 to 5 weeks, and a taper is required
- Marijuana: about 5 days
- Opioids: 4 to 10 days
- Long-acting opioids such as methadone: 14 to 21 days
- Stimulants: 1 to 2 weeks
- GHB: 5 to 12 days
The Importance of Medically Assisted Detox
Cold turkey detox, where you stop using a substance abruptly, is incredibly uncomfortable and causes a feeling of sickness and distress. In extreme cases it is dangerous and results in a medical emergency.
Medical detox is the first step in overcoming a substance-use problem. It should always be followed by an evidence-based rehabilitation programme. At Changes Rehab in Johannesburg, detox is medically managed with 24-hour nursing care and psychiatric oversight.
Many people ask whether they can be safely detoxed at home or outside a medical environment. It is always best to be assessed by a doctor before deciding to stop using a substance of abuse. That doctor can set out safe options for detox and withdrawal management.
When to Get Help
It is always better to get help before withdrawal symptoms occur, so that they and their consequences can be prevented. If your loved one has not told you about their drug use or that they have stopped, seek medical attention immediately when you notice any of the symptoms above.
Remember that alcohol, benzodiazepine, GHB and opiate withdrawal are the ones that most need medically assisted detox.
Changes Rehab in Northcliff, Johannesburg provides medically managed detox with 24-hour nursing care. Our clinical team manages withdrawal symptoms safely, ensuring that you are physically stable and able to move on to the next phase of treatment. Medical aid is accepted, and our admissions team handles pre-authorisation on your behalf.
Call 081 444 7000 or visit our contact page to start the process today.