Withdrawal Syndrome

Withdrawal syndrome, often a formidable hurdle in the path towards sobriety, manifests as a constellation of signs and symptoms following the cessation of narcotic substances. This syndrome, central in the cycle of addiction and recovery, points to the body’s adjustment to the absence of previously regular inputs of drugs or alcohol. This article delves into the intricacies of withdrawal from substances such as ethanol (alcohol), sedative-hypnotics, opioids, stimulants and gamma-hydroxybutyrate (GHB), providing insights into their impact and management.

Withdrawal management aims to alleviate symptoms, prevent complications and pave the way for ongoing treatment post-withdrawal. Treatment may include medications to address specific symptoms such as nausea, tremors or pain. Withdrawal management programs can be undertaken in residential settings, hospitals or even at home under professional guidance to mitigate risks of relapse and ensure safety.

Alcohol Withdrawal Syndrome

Symptoms of alcohol withdrawal vary from mild to severe, depending on the duration and quantity of alcohol consumption. Within 6 hours of cessation, mild symptoms such as anxiety, shaky hands, headache, nausea, vomiting, insomnia and sweating may occur. Between 12 to 48 hours after the last drink, more severe symptoms can manifest, including hallucinations and seizures. From 48 to 72 hours post-cessation, a small percentage of individuals (about 5%) may experience delirium tremens (DTs), characterised by vivid hallucinations, delusions, confusion, a rapid heart rate, high blood pressure, fever and heavy sweating.

Sedative-Hypnotic Withdrawal Syndrome

This category includes benzodiazepines, barbiturates, GHB and γ-butyrolactone (GBL) with withdrawal symptoms that mirror those of alcohol due to similar physiological impacts. The timing of symptom onset varies by substance offering clues to the specific cause. For example, GHB withdrawal symptoms emerge rapidly post-cessation, contrasting with the delayed onset associated with benzodiazepines due to their active metabolites.

Opioid Withdrawal Syndrome

Opioid withdrawal symptoms are the adverse effects experienced when stopping or reducing opioid medicines or when a medication blocking opioids is taken. These symptoms include physical discomforts such as hot and cold flushes, sweating, goosebumps, anxiety, irritability, cravings, gastrointestinal issues like nausea and diarrhea, tremors, watery eyes, runny nose, sneezing, yawning and sleep disturbances. Pain in various forms, such as joint, bone, muscle, abdominal and headaches, can also occur. It’s important to taper off opioids gradually under medical supervision to manage these symptoms effectively.

SSRI Withdrawal Syndrome

Antidepressant discontinuation syndrome symptoms usually start within 2-4 days after stopping an antidepressant. They can include flu-like symptoms (fatigue, headache, achiness, sweating), vivid dreams or nightmares, nausea (sometimes vomiting), dizziness, light-headedness, burning or tingling sensations (paresthesia) and mood changes (anxiety, irritability, agitation, aggression). While symptoms are generally mild, a study showed that 7% of affected individuals experienced symptoms for two months, 6% for a year and 2% had symptoms beyond three years. It’s advised to consult a healthcare provider if experiencing these symptoms.

Neonatal Withdrawal Syndrome

Neonates exposed to addictive substances in utero may experience withdrawal with symptom onset and presentation varying by substance. Alcohol withdrawal in neonates, distinct from fetal alcohol syndrome, can present with agitation, tremors and cardiovascular symptoms. Neonatal withdrawal from opioids and other substances may include a range of symptoms from jitteriness to seizures.

Supporting Someone Through Withdrawal

Supporting an individual through withdrawal necessitates a safe, stable environment and may involve professional help from healthcare providers or addiction services. For caregivers, maintaining personal well-being is crucial, highlighting the importance of self-care alongside providing support.

What is Withdrawal Syndrome? | Addiction Summary

Withdrawal syndrome can be defined as signs and symptoms that occur with the cessation of using a narcotic substance. Get help from qualified counsellors.

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