Withdrawal Timeline and Symptoms

A guide to the withdrawal timeline, symptoms, and treatments for addictive substances.

What is Drug Withdrawal?

When a drug has been consumed for a certain period, the body may become dependent on that drug to function at normal levels, much like how the body is dependent on food and water to survive. When the intake of that drug stops, the entire body, from the brain down to the cellular level, “crave” the drug.¹

If drug dependence has been developed from consuming a substance over an extended time, then drug withdrawal may occur. Drug withdrawal is the set of symptoms that occur after medicinal or recreational drug use stops suddenly or is drastically decreased.

How you feel after ceasing drug use depends on the drugs you’ve been using. Some of the most common withdrawal symptoms include stomach cramps, nausea, vomiting, diarrhea, muscle aches, and sweating.

What is a Withdrawal Timeline?

After you stop taking drugs, your body requires time to heal. Withdrawal symptoms can last from several days to several weeks after someone quits using. With each day, however, the body adjusts and heals itself a little bit more.

The best way to prevent severe withdrawal symptoms is to lower the drug dose slowly and over time.

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Symptoms of Different Drug Addictions

Adderall

Common symptoms of Adderall addiction include:

Racing thoughts
Insomnia
Extreme moods (from elation to depression)
Long-term symptoms include:
Extreme weight loss
Risk of cardiac issues
Stunted growth/failure to gain weight properly
Anger or increasingly aggressive emotions

Someone who is addicted to Adderall may also exhibit a behavior called “doctor shopping,” which refers to visiting more than one doctor to obtain multiple active prescriptions for Adderall.²

Adderall

Common symptoms of Adderall addiction include:

Racing thoughts
Insomnia
Extreme moods (from elation to depression)
Long-term symptoms include:
Extreme weight loss
Risk of cardiac issues
Stunted growth/failure to gain weight properly
Anger or increasingly aggressive emotions

Someone who is addicted to Adderall may also exhibit a behavior called “doctor shopping,” which refers to visiting more than one doctor to obtain multiple active prescriptions for Adderall.²

Alcohol

Symptoms of alcohol addiction may include:³

Spending most of one’s time thinking about or consuming alcohol
Trying to quit drinking but always unsuccessfully
Drinking larger amounts more often than intended
Continuing to drink alcohol even if doing so is harmful to health
Continually drinking alcohol in situations where doing so may be hazardous
Experiencing withdrawal symptoms when not drinking

Benzodiazepines

Benzodiazepine addiction is characterized by the typical symptoms of a substance use disorder:⁴

Spending most of the time thinking about or using benzodiazepines
Trying to quit drug use but always unsuccessfully
Taking higher doses more often than intended
Continuing use even if use is harmful to health
Experiencing withdrawal symptoms when not using
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Klonopin is a commonly prescribed benzodiazepine class drug. Klonopin addiction, even if taking a medically prescribed, low dose, can develop in as little as 2-4 weeks.⁵

Cocaine

Symptoms of cocaine addiction may include:⁶

Spending a large amount of time trying to obtain, use, and recover from use
Feeling that cocaine is “needed” to feel normal or balanced
Withdrawal from social life (e.g. withdrawal from family and friends)
Losing interest in things one used to enjoy
Severe weight loss
Damage to nasal passages from snorting cocaine
Experiencing withdrawal symptoms when not using

Opioids

Symptoms of opioid addiction may include:⁷

Inability to control drug use
Uncontrollable cravings
Drowsiness
Changes in sleep habits
Weight loss
Frequent flu-like symptoms
Decreased libido
Poor or lack of hygiene
Isolation from family or friends
Stealing from family, friends, or businesses
New financial difficulties

Fentanyl

Fentanyl a fully synthetic opioid. Like opioid addiction, symptoms of fentanyl addiction may include:⁸

Xanax

Symptoms of Xanax addiction may include:⁹

Failure to fulfill major role obligations at work, school, or home because of repeated Xanax use
Repeated Xanax use in environments where the user may harm themselves
Repeated Xanax-related legal problems
Continued use of Xanax despite the social or interpersonal repercussions

Drug Withdrawal Timelines and Effects

Adderall

Adderall withdrawal is not medically life-threatening and does not require pharmaceutical intervention. Withdrawal symptoms, which usually appear within 1-2 days after the last dose, are severe tiredness, sleep problems, and mental/mood changes such as depression. These symptoms may last a few days to several weeks.¹⁰

Alcohol

After the last drink, symptoms of alcohol withdrawal may start as soon as 4 to 12 hours and may last up to several days. Symptoms often peak within a few days.¹¹ Mild symptoms, which can last for a few weeks, include:

More severe symptoms include:

Vomiting or belly pain
Being confused, upset, and irritable
Feeling things on the body that are not there
Seeing or hearing things that are not there
Trembling
Being short of breath
Chest pains
Seizures

Severe alcohol withdrawal can be fatal, so those who are at risk for severe withdrawal symptoms should not detox at home unless they work closely with a doctor to manage the symptoms.

Benzodiazepines

Benzodiazepine withdrawal can induce dangerous and sometimes life-threatening effects, so detoxing with medical support is advised. The onset of effects may be hours or a few days, and symptoms can last for several weeks.¹² Common effects can include:

Sleep disturbance
Irritability
Increased tension and anxiety
Panic attacks
Hand tremor
Sweating
Difficulty concentrating
Dry retching and nausea
Some weight loss
Palpitations
Headache
Muscular pain and stiffness

Serious effects can include:

Cocaine

Although the timeline and effects of cocaine withdrawal vary between long-term users and short-term users, it is not medically life-threatening and does not require pharmaceutical intervention. The most common effect of cocaine withdrawal is a “crash,” characterized by the following symptoms:¹³

Dysphoria (a feeling of anxiety and restlessness)
Fatigue and/or difficulty sleeping
Depression which usually dissipates in a matter of hours
Increased hunger
High desire to continue or restart using the substance
Vivid dreams

Cocaine withdrawal symptoms begin within hours to days of the last dose. The crash lasts for 3-4 days, and withdrawal persists for 1 to 10 weeks.

Opioids

Symptoms of opioid withdrawal can include:¹⁴

Rapid heartbeat
Goosebumps
Stomach cramps
Nausea and vomiting
Diarrhea
Muscle aches
Sweating

Some people also feel tense and edgy, sad, anxious, or get the “shakes”. The withdrawal timeline for opioids can start within 24 hours and last up to several weeks, depending on which opioid was being taken and the length of time it was taken.

Fentanyl

Fentanyl withdrawal effects include a host of physical, emotional, and mental symptoms:¹⁵

Chills
Restlessness
Mental/mood changes (including anxiety, trouble sleeping, thoughts of suicide)
Watering eyes
Runny nose
Nausea and vomiting
Diarrhea
Shaking (uncontrollably) and tremors
Sweating
Muscle aches
Sudden changes in behavior

Fentanyl withdrawal generally begins between 6-36 hours after the last dosage and lasts one to two days. It is advised to medically detox fentanyl due to the severity of the symptoms that may occur.

Xanax

Acute Xanax withdrawal symptoms can start 6-12 hours after the last dose, peak around day 2, and resolve in 4-5 days. Protracted symptoms (e.g. psychiatric symptoms and drug cravings) may last for weeks to months.¹⁶

Withdrawal from Xanax, a benzodiazepine, can include the following effects:

Headaches
Trouble sleeping
Restlessness
Hallucinations/confusion
Depression/thoughts of suicide
Nausea
Seizures

Withdrawal from Xanax should be performed under medical supervision.

When is Drug Detox Necessary?

Detox refers to the process of treating someone who is physically dependent on a drug. Detox helps control acute withdrawal symptoms. The state of physical dependence is ended is usually referred to as detoxification.¹⁷

Drug detox is necessary when there are substances in the body that the body needs to get rid of because they produce adverse effects on one’s health or life circumstances. For example, if you cannot stop using a drug, continue using a drug despite the harm it causes, or exhibit unsafe behavior as a result of using a drug, a drug detox may be in order.

For drugs with less severe withdrawal symptoms, detox may be done at home and unsupervised by a medical professional. For substances with severe and dangerous withdrawal symptoms, however, detox should be overseen by a medical professional or done in an addiction treatment facility. Detox can also be medically assisted if symptoms are severe.

What to Expect from Drug Withdrawal

Medications Used in Drug Detox

Withdrawal from benzodiazepines (such as Xanax and Klonopin) and alcohol is associated with life-threatening complications, so certain medications are used in detoxing from these drugs. For alcohol detox, benzodiazepines are commonly administered to prevent seizures, then tapered off. For benzodiazepine detox, a long-acting benzodiazepine (e.g. diazepam, chlordiazepoxide) may be substituted for the benzodiazepine that was being used, then tapered off over time. Other medications are used to treat opioid detox, including Lofexidine, Methadone, and Buprenorphine.¹⁸

Coping with Drug Withdrawal

What To Do:

Take medicine (especially if recommended by a doctor) exactly as prescribed to relieve withdrawal symptoms
Get plenty of rest
Drink plenty of fluids
Stay active (but do not over-exert)
Eat a healthy diet
For alcohol withdrawal, eating foods high in carbohydrates (such as fruit, cheese and crackers, and pretzels) may reduce cravings for alcohol
Look into drug treatment programs
Have a naloxone rescue kit on hand (for opioid withdrawal)
Have someone you trust with you the whole time
Understand that getting through the process is going to be hard, but it will get better

What Not To Do:

It is important to remember that the body adjusts to the absence of opioids quickly. If you take the same dose of opioids as you did before you stopped, you could be at a higher risk of overdose.

Resources

https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
https://drugabuse.com/stimulants/adderall/how-to-help-an-addict/
https://drugabuse.com/alcohol/how-to-help-an-alcoholic/
https://drugabuse.com/benzodiazepines/finding-help-for-addiction/
https://drugabuse.com/benzodiazepines/Klonopin/how-to-help-an-addict/
https://americanaddictioncenters.org/cocaine-treatment/signs
https://www.hopkinsmedicine.org/opioids/signs-of-opioid-abuse.html
https://www.drugabuse.gov/publications/drugfacts/fentanyl
https://drugabuse.com/benzodiazepines/xanax/how-to-help-an-alprazolam-addict/
https://www.webmd.com/add-adhd/adderall-withdrawal
https://healthy.kaiserpermanente.org/maryland-virginia-washington-dc/health-wellness/health-encyclopedia/he.alcohol-withdrawal.aby3752
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.planning-to-stop-taking-benzodiazepine-care-instructions.abr9185
https://www.ncbi.nlm.nih.gov/books/NBK64323/
https://drugabuse.com/opioids/fentanyl/
https://dualdiagnosis.org/fentanyl-risks/withdrawal/
https://americanaddictioncenters.org/withdrawal-timelines-treatments/xanax
http://1.droppdf.com/files/nDw4G/encyclopedia-of-drugs-alcohol-and-addictive-behavior-2nd-ed-vol-2.pdf
https://americanaddictioncenters.org/withdrawal-timelines-treatments