What Caregivers Can Expect During Drug Withdrawal
Drug withdrawal occurs when someone who has become dependent on a substance stops using it. Substance abuse of all types can possibly lead to addiction and withdrawal. Drug withdrawal symptoms can be different depending on the individual, but they are always uncomfortable and difficult to manage. Severe withdrawal symptoms can even be dangerous or lead to a relapse.
As a caregiver, you might experience drug withdrawal in your loved one. If they are quitting drugs or alcohol, your caregiving role may include supporting them as they go through withdrawal. Learn more here about what to expect, so you can better help them get through this difficult time.
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What Causes Drug Withdrawal?
Both drug addiction and alcohol addiction occur when a person regularly uses a lot of one or more substances, that leads to changes in the brain. Drugs and alcohol use cause the release of dopamine, a neurotransmitter that gives you a sense of pleasure.
Over time, and with increased use of substances, the brain needs to release more and more dopamine to get high, and eventually, just to feel normal. These changes in the brain ultimately lead to addiction, or dependence, and withdrawal if the person stops using.
Alcohol or drug withdrawal happen when a person cuts back or completely stops using the substance that they have become dependent on. Withdrawal is the body’s and brain’s response and adjustment to not having the substance.
Why Is It Important For Caregivers To Understand Withdrawal?
As a caregiver, your role depends on your loved one’s health condition. If they are dependent on substances and are trying to quit, withdrawal will become one of their conditions. Drug withdrawal symptoms and severity depend on theindividual, but everyone who uses substances can benefit from withdrawal management.
Your loved one’s physician and other healthcare professionals should be involved as they quit, but you’ll be at home with them, supporting their recovery. It’s important that you understand withdrawal, so you can provide the best care and help them succeed in recovery.
Withdrawal itself isn’t usually dangerous. However, withdrawal from alcohol or benzodiazepines can be dangerous. They can cause severe withdrawal symptoms that are harmful and possibly even life-threatening. If your loved one has become dependent on either of these substances, it is especially important that you involve medical care as they stop using them.
For other types of substance use, the main danger is that withdrawal symptoms will lead to a relapse. Opioid withdrawal is particularly dangerous because of the risk of relapse, which can lead to an overdose.
General Drug Withdrawal Symptoms
Drug withdrawal can occur with several types of drugs. Withdrawal syndrome is not limited to illicit or illegal drugs, like heroin or meth. Certain prescriptions are habit-forming and can cause addiction and later withdrawal syndrome if misused.
Commonly misused prescription drugs include opioids, prescribed for pain, and benzodiazepines, which are usually prescribed for anxiety. Although alcohol is not usually grouped with drugs, it is also addictive and causes withdrawal symptoms in many people.
Some drug withdrawal symptoms are specific to each substance. There are also some general symptoms of withdrawal that can happend from many different types of drug abuse or alcohol abuse:
- Cravings for the substance the person has quit using
- Irritability, anger, and mood swings
- Changes in sleep patterns, either insomnia or sleeping excessively
- Restlessness
- Difficulty concentrating
- Depression or anxiety
Opioid Withdrawal Symptoms
Opioids are highly habit-forming drugs. Prescription opioids are used to manage chronic and serious pain, while illicit opioids include heroin and synthetic fentanyl. Withdrawal from opioid use disorder usually begins within 12 hours after last use and peaks in a couple of days.
Opioid withdrawal syndrome is not inherently dangerous. However, it can put your loved one at risk for a relapse and overdose. Opioid overdose is very serious and is often fatal. It’s important to take advantage of careful opioid withdrawal management and care to lower the risk of relapse and overdose.
Characteristic symptoms of opioid use disorder withdrawal include:
- Agitation and anxiety
- Insomnia
- Muscle aches
- Excessive sweating
- Runny nose
- Cramping and diarrhea
- Nausea and vomiting
- Chills
- Dilated pupils
A person going through opioid withdrawal might seem like they have a severe cold or a bad case of the flu.
Stimulant Withdrawal Symptoms
As with opioids, stimulant abuse can happen with illicit and prescription drug use. Illicit stimulants include cocaine and methamphetamine (meth). Prescription stimulants include amphetamines, like Ritalin and Adderall, which are used to treat ADHD.
Prescription stimulant or cocaine withdrawal is not considered dangerous or life-threatening, but can be uncomfortable and troubling:
- Depressed mood
- Excessive and deep sleep
- Apathetic and lethargic
Someone going through stimulant withdrawal might have a lot of signs of depression. They may sleep a lot, experience a very low mood, and be generally inactive and uninterested in activities or responsibilities. Stimulant withdrawal can take several weeks to resolve.
Benzodiazepine Withdrawal Symptoms
Benzodiazepines are prescription sedatives used for anxiety and as muscle relaxers. Examples include Valium and Xanax. Benzodiazepines are not as habit-forming as prescription opioids, but some people misuse them and become addicted.
Benzodiazepine withdrawal can be serious and life-threatening. If your loved one is trying to stop using these drugs, their detox should be carefully managed with medical supervision.
Withdrawal from sedatives can cause insomnia, irritability, anxiety, sweating, nausea, increased heart rate, tremors, headaches, and muscle pain. The mental health symptoms can be severe and may include hallucinations or panic attacks. More seriously, benzodiazepine withdrawal can cause seizures, psychosis, or suicidal ideation.
Alcohol Withdrawal Symptoms
Alcohol is often classed differently from drugs, but like many drugs, alcohol is addictive. If your loved one is trying to stop drinking, they may experience withdrawal. For alcoholics who have been drinking heavily for a long period of time, alcohol withdrawal syndrome can be very dangerous, even life-threatening.
It’s important you talk to your loved one’s doctor about their alcohol addiction before planning a detox. Certain medications can reduce the severity of withdrawal symptoms, reduce the risk of relapse, and prevent the most serious side effects of withdrawal.
Some common alcohol withdrawal symptoms include:
- Shaking and tremors
- Insomnia
- Anxiety with increasing intensity
- Gastrointestinal issues
- Hyperactive reflexes
- Excessive sweating
- Increased heart rate
- Elevated blood pressure
- Dilated pupils
Alcohol withdrawal can be very dangerous if it becomes severe. Symptoms of severe alcohol withdrawal include extreme agitation, disorientation, hallucinations, seizures, and delirium tremens (DT). DT is the most severe sign of withdrawal from alcohol. DT causes all the other symptoms of withdrawal along with severe tremors, disorientation, and psychosis. It should be treated as a medical emergency.
Withdrawal Timeline & Severity
Drug withdrawal symptoms can be mild or severe, or anything in between. How severe the symptoms are depends on several individual factors:
- The type of substance use
- How long they have been taking the drug
- How much of the drug they used and the frequency
- Underlying health conditions
The duration of withdrawal from substance use also varies by individual and drug type. The withdrawal process can begin within hours of the last use of a substance, or it might not begin for a day or two. The good news is that withdrawal symptoms often peak within a few days and then begin to taper off.
Post Acute Withdrawal Syndrome
As a caregiver, it’s important to understand what to expect in terms of symptoms of withdrawal, but also how long it might last. The duration of withdrawal is highly dependent on individual factors, but for many, physical withdrawal symptoms resolve within days or weeks.
In some cases, addicts in recovery experience post-acute withdrawal syndrome, also known as PAWS. It’s often related to alcohol addiction, but PAWS can happen after any drug addiction.
PAWS occurs when withdrawal symptoms linger for weeks, months, or even years after stopping drug or alcohol use. These are not the intense physical symptoms experienced in acute or early withdrawal. They are milder but still uncomfortable, disruptive, and often related to mood:
- Difficulty sleeping
- Fatigue
- Difficulty concentrating
- Mood swings
- Depression
- Low motivation
- Muscle aches
As with acute withdrawal, PAWS symptoms will eventually lessen. It just takes a lot longer. Your loved one may experience symptoms that come and go, often increasing when they are stressed. Talk to their doctor if they seem to be experiencing withdrawal more than a few weeks after stopping drug or alcohol use.
Withdrawal Management – How Is Withdrawal Treated?
Quitting drug use or drinking is never easy. The difficulty of quitting is just as difficult as withdrawal. The worse and more long-lasting the withdrawal symptoms are, the greater the risk of relapse. If your loved one is quitting, don’t let them do it alone. They can benefit from substance abuse treatment.
In addition to support from their loved ones and caregivers, your care recipient can benefit from addiction medicine and medical care. There are many options for addiction treatment. For example, they might choose to only undergo a medical detox for a few days to get over the worst of withdrawal.
Drug detox can be very helpful. It often includes supportive care, like intravenous fluids and supplements, as well as medications to treat symptoms like nausea, insomnia, or headaches. The patient may also receive specific detox medications. For example, patients in alcohol detox can benefit from benzodiazepines.
There are also specific medications for withdrawal from opioid use disorder. Naloxone can prevent relapse by blocking the effects of opioids. Buprenorphine reduces cravings to prevent relapse.
Medically supervised detox treats withdrawal, but it is just one small step on the road to addiction recovery. Your loved one will need ongoing support. Relapse is a real risk, even after withdrawal symptoms have resolved. It’s important to address the underlying issues with therapy, support groups, and, in some cases, ongoing medication use.
Protecting Yourself As A Caregiver
Being a caregiver presents many challenges. It can be physically and emotionally demanding work, especially when you care for someone you love. The challenges are even greater when the care recipient is going through a difficult drug use withdrawal.
Your loved one in withdrawal might seem like a completely different person. They might be angry or depressed. They are likely to be in pain and irritable. They might even become emotionally or physically abusive. As a caregiver, you want to support and help your loved one, but you also need to protect yourself.
Start with a good plan that involves others, so you’re not doing this alone. Talk to your loved one’s doctor to create a plan that may include medical care. You should also enlist the support of other family members or friends, even if you are the primary caregiver.
While lining up treatment and support for your loved one, consider getting support for yourself as well. Support groups for the families of people with an addiction can be very helpful. They provide a safe space for sharing difficult feelings and learning from the experiences of others. One-on-one therapy can also be very helpful.
It makes sense to prioritize someone going through something as difficult as drug withdrawal, but don’t forget your own self-care. Make sure you get enough sleep, exercise, and good food while providing care. Hand off responsibilities to a trusted loved one as needed to give yourself time to stay well.
Finally, be sure to set boundaries. This means setting both emotional and physical boundaries. You don’t have to take abuse, emotional or physical, from someone just because they are suffering. If you feel unsafe with your loved one who is in withdrawal, get help. Your safety is important.
Drug withdrawal syndrome is a very serious situation. The more you learn about it, the better prepared you will be to support a loved one through this difficult time.
References
- Healthdirect Australia. (n.d.). Addiction withdrawal. Healthdirect.
- Ries, R., & Cullison, S. (n.d.). Substance withdrawal clinical presentation. Medscape.
- MedlinePlus. (n.d.). Substance use disorder. MedlinePlus.
