“The withdrawal period of opiates like heroin and oxycontin include a very intense one to three days where patients can have seizures, uncontrollable vomiting, diarrhea, and other extreme symptoms,” Dr. Hanson says. (There are medications and strategies available to help reduce the intensity of these symptoms as much as possible.) By day three to five, symptoms are less intense, but he says patients are typically tired and in a subdued state of being.
“While patients may no longer be in the pain they endured the first one to three days, they may be barely coherent,” he explains. Then, within seven to eight days, this phase is over, and the psychological work can begin.
As noted above, heroin is an opiate drug that produces withdrawal symptoms as soon as 6 to 24 hours from the last use, with a peak around 24 to 48 hours. Complete withdrawal can last about five to 10 days but may take longer for some people.2
Withdrawal for short-acting benzodiazepines like oxazepam, lorazepam, and triazolam typically begins one to two days after the last dose. Long-acting benzodiazepines such as diazepam, chlordiazepoxide, flurazepam, and clorazepate take three to seven days for symptom onset.8 The overall withdrawal period can last one to two weeks, depending upon the amount of use and length of use. That said, Dr. Hanson points out that benzodiazepines withdrawal can admittedly be very difficult., Getting through it without a relapse not only requires a strategy for handling biochemical cravings, but also addressing any psychological aspects, like the condition the benzos were originally intended to treat. (More on this in a bit.)
Acute symptoms in cocaine withdrawal generally last seven to 10 days as your body rids cocaine from your system. Symptoms may begin as early as 24 to 48 hours after last use.2
Are there complications from withdrawal?
Withdrawing from some substances once you’ve become dependent, like opioids, alcohol, and benzodiazepines, can result in dangerous, life-threatening symptoms, especially if you try to detox on your own.
Serious symptoms like seizures, hallucinations, delirium, high blood pressure, and dehydration can all cause short and long-term complications, and in some cases, death. There are medically monitored detox programs and tapering protocols that can help reduce the risk of complications and improve recovery. But these can be hard to access for many people, with the reasons behind this lack of access ranging from stigma to cost and beyond.2
Are there withdrawal treatments and medications?
Withdrawal symptoms from drugs or alcohol are unpleasant, causing many people to continue their substance use. Feeling nervous or scared about this process is normal, but know that you are not alone. If you want help, several treatment options may be available to you, ranging from counseling to medications to medical detox.
The gold standard for safely managing withdrawal symptoms is through medical supervision. Without medical supervision, Dr. Marcum says you may suffer from seizures or other life-threatening consequences. She also recommends counseling from mental health professionals and collaboration with psychiatry to treat co-occurring mental health disorders.
Dr. Hanson agrees and adds that medical detox is just one part of the process—the other half addresses the emotional and psychological issues that led to the substance use disorders in the first place. “We have gotten very good at treating patients medically through detox, but appropriate treatment for drug and alcohol withdrawal also involves trauma resolution work, which looks at past traumas that are still impacting us now and creating the symptoms of substance abuse,” Dr. Hanson says. It’s important to note that trauma isn’t always the cause of substance use. It can also occur from simple recreation use, experimentation, or an addiction to prescription pain medications after a procedure.