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Substance Addictions

Drug Withdrawal Symptoms, Timelines & Treatment

Written By Brian Davis
Reviewed By Tiffany Green
Medically Reviewed By Dr David Barker
Updated July 21, 2023

It’s just after 3 a.m., roughly a day and a half since John’s dad gave him the ultimatum: “Next time you’re high under my roof, you’re out.” John tosses and squirms under his nettle blanket, his mind foggy yet filled with an intense, unshakable craving. He reaches for a sip of water, but his uncontrollable shaking doesn’t allow him any relief as the water soaks into the already-damp bedding. He cries out as the invisible voices tell him he’s going to die. He wants to die. He wants more of what has already taken his job, his home, his relationships, and his self-worth –or he wants to die.

John’s predicament might sound like an over-exaggerated B-film about drug abuse, but sadly, situations similar to these play out on a daily basis in thousands of UK households. Over the last decade, our collective appetite for drugs has increased by about 23% (United Nations Office on Drugs and Crime), and while cannabis and alcohol remain the two most commonly consumed substances (along with nicotine), hard drugs such as cocaine, opioids, and amphetamines contribute more and more to individual and societal harm. 

In addition to the direct damage that these drugs do to our persons, families, and communities, they also have one final trick to keep the abuser abusing – withdrawal symptoms. These refer to the physical and mental symptoms that someone who has developed even the slightest addiction to drugs will experience when they stop using, and very often, they’re so painful and uncomfortable that someone trying to get clean simply can’t take it anymore and turns back to the drug for relief. 

If you yourself have fallen victim to the often-glamorised allure of drugs, or you love someone else who has, understanding the maelstrom of effects you’ll experience as the body rids itself of deadly toxins can help you physically and emotionally prepare, maximising your chances of quitting for good. 

Drug Withdrawal Mechanisms

Withdrawal symptoms encompass the full and largely-predictable range of physical and psychological symptoms associated with the abrupt absence of a substance that the body has become adapted to and come to rely on for maintaining normal function. It’s important to note that different substances can have very different withdrawal symptoms and intensities, but even drugs that ‘don’t have physical withdrawal symptoms’ in the public’s mind, such as cannabis, LSD, or psilocybin mushrooms, can cause irritability, sleeplessness, decreased appetites, and general irritability. While these symptoms are a far sight from the potentially fatal seizures of, for example, benzodiazepines or alcohol withdrawal, don’t make the mistake of thinking that using these drugs will be consequence-free when deciding to stop. 

While a detailed description of the biological processes that cause withdrawal symptoms is best discussed in medical journals, in a nutshell, drugs cause withdrawal symptoms through two mechanisms: 

  1. The Rebound effect suggests that a body will attempt to reestablish homeostasis (a balance of biological processes and chemicals) when a substance such as a drug disrupts normal functioning. For example, when an anti-anxiety drug like benzodiazepine suppresses the creation of certain neurotransmitters, the body will rebound and overproduce these neurotransmitters in an attempt to counterbalance the effect.
    The rebound will have the opposite effect of the drugs taken, so the rebound for benzodiazepine will be fresh new anxiety, restlessness, and other symptoms that benzos are supposed to prevent. It’s important to note that the rebound effect doesn’t only apply to narcotics but to a wide range of drugs and medicines. Suddenly quitting sleeping aids could lead to insomnia;  antacids can cause acid reflux etc. (Lerner and Klein).
  2. The Opponent-Process effect describes how the ‘high’ from drugs diminishes over time (tolerance) and why negative aftereffects occur once the drug wears off (withdrawal). The process starts when one takes a drug that has a reaction (we’ll refer to this as the ‘A process’). This causes the body to seek balance, resulting in a ‘B process’ to counteract the effects of A. Over time, the A process weakens as the user develops a tolerance or resistance to the drug, while the B process strengthens, leading to more severe withdrawal symptoms (Radke et al.).

For example, when someone takes an opioid, it (indirectly) causes the brain to flush itself with feel-good endorphins (A process). The body responds to this oversupply by reducing its own output (B process). With repeated use, the body develops a tolerance, reducing the pleasurable effects of the opioids at the same time that the body naturally produces fewer and fewer endorphins. This lack can cause withdrawal symptoms such as irritability, confusion, seizures, hallucinations, and many more.

Drug Withdrawal Symptoms & Timelines

Just as alcohol withdrawal symptoms (AWS) can vary between individuals based on a range of factors, drug withdrawal can also present different symptoms at different intensities, on different timelines. Even patients with similar physical health profiles could manifest different symptoms for the same drug based on individual factors such as genetic predisposition, metabolic rate, or liver function; and this doesn’t even begin to touch on factors such as co-occurring mental or psychological health factors. 

All that being said, there are certain symptoms that one would typically associate with different types of drug withdrawal. While pretty much all drugs leave anxiety and irritability in their wake, severe withdrawal symptoms for antidepressants (SSRIs) are different from severe cocaine withdrawal symptoms, which are in turn different from some of the severe sedative-hypnotic (Zolpidem, Zopiclone, etc.) withdrawal symptoms. 

You can consult the table below for a breakdown of some of the most common drug withdrawal symptoms. Again, this should only be used as a rough guide for a general understanding of drug withdrawal symptoms and their timelines. Gladstones Clinic cannot stress enough how important it is to seek medical guidance and counselling when attempting to stop using drugs, as a medically supervised detox can greatly decrease the associated pain and discomfort while simultaneously increasing the odds of a successful recovery.

Drug and Rough Timeline Common Symptoms More Rare Symptoms Presentation (mild, moderate, severe)


Onset: 1-4 days depending on specific benzo

Duration: Varies greatly (weeks to months)

Anxiety, insomnia, tremors, sweating Delirium, psychosis, seizures, panic attacks

Mild: restlessness, insomnia

Moderate: increased anxiety, tremors

Severe: delirium, seizures, psychosis, panic attacks


Onset: 8-24 hours after last use

Duration: 4-10 days (Select symptoms may last weeks or months)

Muscle aches, anxiety, insomnia Opioid withdrawal syndrome: rapid heart rate, dehydration

Mild: muscle aches, restlessness

Moderate: abdominal cramps, nausea

Severe: rapid heart rate, dehydration, seizures


Onset: 6-48 hours after last use

Duration: Up to a few weeks

Fatigue, depression, increased appetite Paranoia, psychosis, suicidal ideation

Mild: fatigue, depression

Moderate: increased appetite, irritability

Severe: paranoia, psychosis, suicidal thoughts


Onset: 8-24 hours after last use

Duration: Up to several weeks

Fatigue, depression, increased appetite Psychosis, hallucinations

Mild: fatigue, depression

Moderate: increased appetite, irritability

Severe: psychosis, hallucinations


Onset: 1-3 days after last use

Duration: 1-2 weeks (Select symptoms may last for months)

Irritability, insomnia, decreased appetite Increased anxiety, restlessness, vivid dreams, chills

Mild: irritability, difficulty sleeping

Moderate: increased anxiety, restlessness, sweating

Severe: intense anxiety, vivid nightmares

Antidepressants (SSRIs)6

Onset: 1-4 days depending on specific benzo

Duration: Varies greatly (weeks to months)

Dizziness, nausea, flu-like symptoms "Brain zaps" (electric shock sensations in the head)

Mild: dizziness, nausea, flu-like symptoms

Moderate: increased anxiety, mood swings

Severe: debilitating brain zaps, intense anxiety


Onset: 2-4 days after last use

Duration: Varies greatly, typically up to 3 weeks.

Rebound insomnia, increased anxiety Delirium, hallucinations, seizures

Mild: difficulty sleeping, increased anxiety

Moderate: heightened restlessness, confusion

Severe: delirium, seizures, hallucinations

Drug Withdrawal Treatment

One of the biggest barriers to people quitting their drug habits for good is the withdrawal symptoms described in the table above. All of these symptoms (with the possible exception of an increased appetite) have a net negative effect on our physical and psychological well-being. These withdrawal symptoms are always uncomfortable and can become painful, driving one right back to the loving embrace of the drug – pain-free and content. By treating the withdrawal symptoms, one has a much better chance of recovery and avoiding relapse.

Whether one decides to go at it alone or seek medical assistance in ending drug abuse, for all the drugs mentioned above (and ones not mentioned), you can reasonably expect a detox or detoxification period to start within a few hours to a few days of the last use. During the detox period, the symptoms will reach their highest level of intensity, and depending on the drug, individual, and circumstances, one might need medical or pharmaceutical intervention to alleviate pain or discomfort. Although severe withdrawal symptoms from substances like opioids and amphetamines can be brutal, for lack of a better word, withdrawal-symptom-related fatalities are extremely rare. Unfortunately, the same cannot be said for alcohol withdrawal where severe instances of delirium tremens (DT) can and do cause fatal seizures. 

Typical drug withdrawal treatment again varies between classes of drugs but could include tapering down drug use to minimise withdrawal symptoms, treating symptoms such as insomnia or nausea directly, as well as pharmaceutical intervention. Not all classes of drugs have widely approved medications available to treat the symptoms of withdrawal; however, opioid abusers could receive Methadone, Buprenorphine, Naltrexone, or Clonidine to alleviate cravings and symptoms, while long-acting Benzodiazepines could be prescribed to help someone avoid the worst of Benzo-related symptoms. Pharmaceutical intervention for the treatment of drug withdrawal symptoms must take place under medical supervision. A lot of the medicines used in the treatment of drug abuse have abuse potential themselves, making them unsuitable for over-the-counter prescriptions. 

Once one is over the hump of the withdrawal symptoms, all the literature on drug rehab points to continued therapy for the best chance at a complete recovery. This could take the form of one-on-one sessions with a counsellor or therapist, or joining a support network or group. Full recovery from drug abuse doesn’t tend to stick to a predetermined timeline and could range anywhere from a couple of weeks to a lifetime.

Gladstones Clinic Drug Rehab

For more than two decades, Gladstones Clinic has been helping people from all walks of life reclaim their lives from the grip of drug abuse. Our highly trained and experienced addiction specialists have years of first-hand experience in dealing with addiction and withdrawal of all types and employ modern, evidence-backed approaches to dealing with detox and primary care. 

Gladstones Clinic looks forward to being your partner in recovery If you or a loved one are serious about ending drug abuse. Our fully-integrated and holistic non-12-step program has proven time and time again that even those who feel completely lost and hopeless can make a full and permanent recovery with dedicated and understanding support and care. 

For more information about specific drugs or addiction treatments, you can visit the following pages on our site:

Our team is available to provide you with valuable information, support, and guidance.

Please feel free to contact us with any of your questions about us, our processes, or to learn more about addiction-beating resources.

Works Cited

Connor, JP, et al. “Clinical management of cannabis withdrawal.” Addiction, vol. 117, no. 7, 2022, pp. 2075-2095. National Library of Medicine,,over%207%20days%20of%20abstinence. Accessed 17 17 2023.

Lerner, Alicja, and Micheal Klein. “ependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.” Brain Communications, vol. 1, no. 1, 2019. Brain Communications, Accessed 14 07 2023.

Morton, Alexander W. ““Cocaine and Psychiatric Symptoms.”” Primary care companion to the Journal of clinical psychiatry, vol. 1, no. 4, 1999, pp. 109-113. National Library of Medicine, Accessed 17 07 2023.

“Opiate and opioid withdrawal.” MedlinePlus, 30 April 2022, Accessed 17 July 2023.

Papp, Alexander, and Julie Onton. “Brain Zaps: An Underappreciated Symptom of Antidepressant Discontinuation.”,, 2018, Accessed 17 07 2023.

Petursson, H. “The benzodiazepine withdrawal syndrome.” Addiction, vol. 89, no. 11, 1994, pp. 1455-1459. Wiley Online Library, Accessed 17 07 2023.

Radke, Anna, et al. “Articles, Behavioral/Systems/Cognitive An Anatomical Basis for Opponent Process Mechanisms of Opiate Withdrawal.” The Journal of Neuroscience, vol. 31, no. 20, 2011, pp. 7533-7539. JNeorosci, Accessed 14 07 2023.

Shoptaw, SJ, et al. “Treatment for amphetamine withdrawal.” The Cochrane database of systematic reviews, vol. 2009, no. 2, 2009. Cochrane Library, Accessed 17 07 2023.

United Nations Office on Drugs and Crime. “2023 World Drug Report.” United Nations Publications, 2023, pp. 12-20. United Nations Office on Drugs and Crime, Accessed 14 07 2023.

Weaver, Michael F. “Prescription Sedative Misuse and Abuse.” The Yale journal of biology and medicine, vol. 88, no. 3, 2015, pp. 247-257. National Library of Medicine, Accessed 17 17 2023.

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