Withdrawal syndrome

Specialty of GP (general practioner)

What is withdrawal syndrome?

Withdrawal syndrome is a set of both physical and mental reactions suffered by a person addicted to a substance when they quit. Symptoms vary according to the substance and the length of time the patient has been taking it. 

Tobacco withdrawal syndrome affects 85% of smokers who decide to quit smoking, since nicotine is one of the substances that generate the greatest dependence. The majority of signs and symptoms of tobacco withdrawal syndrome appear within the first 30 days after quitting, intensifying in the first few days and then slowly decreasing after around the fourth day.

What are the symptoms of withdrawal syndrome?

Withdrawal syndrome will present with different symptoms depending on the individual patient, the substance to which the patient is addicted, and the degree of their addiction.

In general terms, with most addictive substances, those affected by withdrawal symptoms will have an incredibly strong desire to take the substance again. This is often accompanied by irritability, personality changes, mood swings, or difficulty in concentrating. Typical symptoms by substance include:

  • Alcohol addiction: Chills, tremor, weakness, nausea, headache and dehydration.
  • Nicotine addiction: Desire to smoke, irritability, tension, headache, drowsiness or insomnia, concentration problems and increased appetite and weight gain.
  • Opioid addiction (morphine, heroin and opium): Agitated breathing, yawning, a runny nose, sweating, chills, goose bumps, excessive tear formation, alertness, hyperactivity, fever, increased heart rate, dilated pupils, muscle cramps, loss of appetite, abdominal pain and diarrhoea.
  • Addiction to stimulants: Tiredness and drowsiness, or restlessness and nervousness, depression, malaise, inertia, instability, and, in some cases, delusions and hallucinations.

Why does withdrawal syndrome occur?

The addictive components within substances like alcohol, tobacco or cocaine act on the brain and nervous system and that creates a dependence on them. The body adapts to the presence of these substances and the brain changes, believing that it can only function normally with these substances. Without them, it takes a while to reset, and in the meantime symptoms of illness can manifest.

Can it be prevented?

The most effective way to prevent withdrawal is not to consume substances that can cause addiction in the first place. Once addicted, it is likely that the individual will suffer at least some withdrawal symptoms upon trying to quit. However, once the symptoms pass, being clean from the substance leads to improvements in health and usually greater happiness in life.

What is the treatment for withdrawal syndrome?

Some of the symptoms can be treated individually, for example, putting a blanket around someone suffering chills due to withdrawal. In the case of giving up powerful opioid drugs like heroin, whose withdrawal symptoms can be extremely unpleasant, medications are sometimes used to make the detox as bearable as possible and take the edge off cravings. This can only be prescribed by a health care professional after a full assessment of the patient.

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