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These are the Stages of Withdrawal

The stages of withdrawal will vary depending on the individual, drug of choice, and length of time using

When a person has become physically dependent on drugs or alcohol, it's likely they will experience nasty withdrawal symptoms if usage stops abruptly. Yet withdrawal isn't just a singular event. Instead, detoxing from drugs or alcohol can be broken down into four primary stages of withdrawal that are ranked on their severity.

Four Stages of Withdrawal

Stopping use of any addictive drug suddenly after a period of prolonged use can cause withdrawal symptoms. The length and severity of each person's symptoms will vary, depending on the type of drug being taken, the length of use and severity of the addiction, the dose being taken prior to detox, and the person's physical and mental health at the time of detox.

Throughout the withdrawal period, the person will progress through four stages. Once again, the actual length of time each person spends in each of the stages of withdrawal is dependent on a range of factors.

First-Stage Withdrawal

Also known as early-stage withdrawal, the first stage of withdrawal can begin within a few hours of taking the last dose. For people detoxing from opiate drugs, symptoms can begin within 4 to 6 hours after the last dose. For people detoxing from alcohol, early-stage symptoms can emerge within 8 to 12 hours after the last drink.

While detoxing from opiate drugs can be excruciatingly painful, the symptoms aren't usually life-threatening. By comparison, detoxing from alcohol might seem much less severe at first, but have the potential to become dangerous and even life-threatening.

At first the symptoms of detoxing from alcohol are relatively mild and may include:

  • Nausea and vomiting
  • Headaches
  • Irritability
  • Tremors and shakes
  • Unusually heavy sweating
  • Confusion
  • Hallucinations
  • Anxiety

Symptoms of first-stage withdrawal tend to peak in severity in one to three days, although some people may find that symptoms can extend for longer periods of time.

Second-Stage Withdrawal

The second wave of alcohol withdrawal symptoms can be more severe and may also need medical attention. A person going through stage two of detox may still continue to experience some of the same symptoms from stage two, although many may worsen over this time.

Common symptoms of second-stage alcohol withdrawal also include:

  • Loss of bowel and bladder control
  • Breathing difficulties, labored breathing, or faster breathing rate
  • Hallucinations
  • Increased heart rate
  • High blood pressure
  • Elevated body temperature
  • Fullbody muscle rigidity
  • Insomnia
  • Depression

Third-Stage Withdrawal

The third stage of withdrawal can begin from four to five days of stopping drinking and can extend for as long as two weeks. Around 30% of people experiencing third-stage withdrawal symptoms of alcohol are at risk of developing 'delirium tremens', or DTs, a dangerous condition that may require emergency medical assistance. Common symptoms of the DTs may include:

  • Grand mal seizures
  • Delirium and hallucinations
  • Disorientation and confusion
  • Full body muscle tremors
  • Night terrors and nightmares
  • Irregular heartbeat

Approximately 15% of people who enter into third-stage withdrawal symptoms of alcohol detox and who do not receive medical treatment will die. The predominant causes are cardiovascular failure (heart attack) or respiratory failure (stopped breathing).

Fourth-Stage Withdrawal

Of all the stages of withdrawal, stage four is perhaps the least well-understood by recovering people. Often known as Post-Acute Withdrawal Syndrome (PAWS), symptoms of stage four can extend for weeks or even months after the last drink.

There are usually fewer physical symptoms during the PAWS stage, but psychological symptoms may persist. These can include:

  • Mood swings
  • Low enthusiasm
  • Fatigue
  • Sleeping disturbances
  • Irritability
  • Anxiety
  • Depression

One of the more common drug withdrawal remedies used in alcohol rehab centers includes careful use of benzodiazepine drugs, such as lorazepam (Ativan) or chlordiazepoxide (Librium). The objective of using benzodiazepine drugs during alcohol detox is to reduce the level of hyperactivity the brain enters into after alcohol consumption is stopped, which subsequently reduces the severity of some withdrawal symptoms and helps to manage cravings.

Other simple drug withdrawal remedies may include a proper nutrition plan. It's common for many recovering alcoholics to suffer from malnutrition, as alcohol interferes with the way the body absorbs nutrients from food. Adding nutritional supplements to a healthy, nutritious diet plan can help ease some of the more overt physical symptoms associated with withdrawal.


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