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.
Why is withdrawal management and detox important?
Withdrawal symptoms are the cluster of physical and psychological experiences that arise when someone tries to stop an addictive behavior. A recent integrative model of addiction describes them as muscular tension, irritability, anxiety, restlessness, insomnia, autonomic arousal, and diffuse subjective suffering without a clear object. The pattern is inward-directed, with the person feeling immobilized by internal conflict and experiencing what the author calls “restlessness that leads nowhere.”
These symptoms appear in both chemical and behavioral addictions, gambling, gaming, compulsive sexual behavior, even when no exogenous substance is involved. The pattern points to withdrawal as the phenomenology of self-suppression rather than a purely chemical deficit.
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 of the substance and the length of period that you’ve 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. If a person only drinks once in a while, he or she is unlikely to experience withdrawal symptoms.
However, if a person has suffered from alcohol withdrawal symptoms in the past, they are much more likely to experience them again when they stop using alcohol.
Withdrawal is caused by how the brain has adapted to regular high volumes of alcohol and, when the alcohol is removed, the brain continues to function in this “keyed-up” or hyper “awake” state which results in negative symptoms.
Timeline Of Alcohol Withdrawal Symptoms
| Timeframe | Symptoms | Severity |
| 6 hours after the last drink | Anxiety, tremors (shaking hands), headache, nausea and vomiting, insomnia, sweating | Mild to moderate |
| 12–48 hours after the last drink | Hallucinations, seizures | Serious |
| 48 hours–7 days after the last drink | Delirium tremens (DTs): severe hallucinations and delusions, confusion, racing heart, high blood pressure, fever, heavy sweating, dehydration, loss of consciousness | Life-threatening |
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.
If you know someone who is experiencing alcohol withdrawal, or who plans to quit heavy drinking abruptly, seek 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 increase the chances of a sustained recovery and long-term abstinence from alcohol.
Signs And Symptoms Of Heroin Or Opiate Withdrawal
Withdrawal symptoms from heroin or other opiates (for example codeine) is not usually life-threatening but it can be severely uncomfortable and difficult for a person to withstand without treatment.
Providing withdrawal management “in a way that reduces the discomfort of patients and shows empathy for patients can help to build trust between patients and treatment staff,” thereby increasing the likelihood of long-term successful rehabilitation.
Detox for opiates consists of care and medication aimed at combatting each symptom.
Symptoms Of Opiate Withdrawal Within The First 24hrs Include:
- 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 and reducing the dose slowly using the same drug or a different sedative.
Do not quit these drugs cold-turkey or try to taper the drugs yourself. Medical professionals are needed to regularly check heart function and breathing during withdrawal from benzodiazepines.
Symptoms Of Withdrawal From Benzodiazepines Within The First 4 Days Include:
- 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 and is dependent on the type of drug used:
| Substance | Typical Withdrawal Duration |
| Alcohol | 5 – 7 days |
| Benzodiazepines | 1 – 5 weeks (taper required) |
| Marijuana | 5 days |
| Opioids | 4 – 10 days |
| Long-acting opioids (methadone) | 14 – 21 days |
| Stimulants | 1 – 2 weeks |
| GHB | 5 – 12 days |
The Importance of Medically-assisted Detox
Cold turkey detox, where you stop abusing a substance abruptly, from the above-mentioned drugs is incredibly uncomfortable, causing a feeling of sickness and discomfort. In extreme cases, it can also be dangerous and result 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 if 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. This medical professional will be able to give an individual safe options for detox and withdrawal management.
When To Get Help
It is always better to get help before withdrawal symptoms occur in order to prevent them and their consequences. If your loved one has not told you about their drug abuse or that they have stopped using substances, seek medical attention immediately if you notice any of the above-mentioned withdrawal symptoms.
Remember that alcohol, benzodiazepine, GHB and opiate withdrawal are the most important drugs that need medically-assisted detox to stop using.
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.