Drug withdrawal syndrome: its types and symptoms

It is common to hear the expression "be with the monkey" when talking about drug addicts who are experiencing tremors, nervousness or angry outbursts at a time when they do not have drug.

These are situations in which these people are suffering greatly and experience variable symptoms. It is a colloquial way of talking about withdrawal syndrome, a problem that we are going to talk about in this article.

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What is Abstinence Syndrome?

Withdrawal syndrome is understood as the set of symptoms caused in the body physically and mentally dependent on a substance before the abrupt withdrawal of this one. Said withdrawal may refer to a complete cessation of consumption or to a reduction in quantity and / or frequency, and symptoms are not due to other medical or mental illnesses (although it may exacerbate symptoms of some disease).

Generally, the withdrawal of consumption is intentionally caused by the dependent subject, in order to eliminate the aversive consequences that the addiction is causing in his life. They can also be caused by involuntary circumstances in which it is not possible to access the substance in question, such as hospitalization, travel or imprisonment. A third option is that the subject cannot acquire it despite not having the will to stop consumption, due to lack of suppliers or the economic capacity to acquire it.

Withdrawal syndrome generates a great level of suffering and discomfort. The specific symptoms of this type of syndrome will depend on the type of substance that is being consuming, being generally the opposite of those that would appear with an intoxication of said substances. Generally, craving or intense desire and craving for consumption usually appear in response to the discomfort generated by the absence of substance. Other common symptoms are tremors and spasms, headaches, muscle pain, digestive problems such as nausea and vomiting, dizziness, agitation or hallucinations.

The evolution of the symptoms and their intensity depend not only on the type of drug but also on the type, quantity and frequency of previous consumption, being linked to the level of dependence and addiction presented by the subject. In addition to the drug used itself, the problems associated with the withdrawal syndrome will intensify if the cessation of use occurs in an environment where it is easy to acquire it. Also the way of seeing the world or of perceiving and facing problems will have an effect, having greater discomfort for example inhibited people who do not express their feelings (especially negative).

• Related article: "Delirium tremens: a severe alcohol withdrawal syndrome"

Why is it produced?

The reason for withdrawal is something that many people, especially those who suffer from it, wonder. The direct motive is the cessation or sudden reduction of consumption, which has been made in such a way that the body of the subject. The body has become accustomed to the substance, generating a tolerance to it (which in turn is what causes consumption increases in quantity and frequency) and the body gets used to working with the substance.

The body, balanced before the acquisition of dependence, learns to maintain a new balance in which the drug or substance in question comes into play. The substance, which initially served as a reinforcer, over time loses part of this role and becomes necessary to avoid the discomfort associated with its lack.

An abrupt withdrawal makes the organism, which depended on this substance, suddenly find that it is missing something that made it work. The internal balance or homeostasis that the body had learned to maintain with the drug it suddenly becomes unbalanced, generating the withdrawal syndrome until it can keep itself balanced. But it depends on how the withdrawal is done, the imbalance can have very severe repercussions.

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The need for a gradual withdrawal

It is important to bear in mind that the withdrawal of the substance should not be done suddenly. And it is that despite the fact that the cessation of consumption in drug addicts is essential and something that can save their lives (both in the sense figuratively as literal), suddenly cutting off the supply of a substance on which our body is dependent can have consequences fatal. The withdrawal syndrome is not something to be taken as a joke: it is a dangerous reality that in many cases can have permanent consequences, lead to coma and even death.

In this sense, the type of drug must be taken into account: It is not the same to disengage from coffee than from cocaine or heroin. Also of the existing level of dependency. Withdrawal is necessary, but must be done in a controlled way (often different drugs are used, for example), scheduled and gradual to avoid severe physiological effects and reduce the risk of a withdrawal syndrome dangerous for the lifetime.

It is necessary to let the body get used to functioning without so much substance until it works completely without it. Sometimes the use of substitute substances may be necessary, such as the methadone, as long as substance use does not occur but dangerous symptoms are kept at bay, the internment in detoxification centers or hospitalization of the subject to keep him stabilized. In some cases, a subject has been put into an induced coma to have better control of the situation.

Alcohol, benzodiazepines and opiates are some of the main substances with withdrawal syndromes that could become life threatening, mostly due to cardiorespiratory failure. It is therefore necessary to schedule its withdrawal.

Different types of withdrawal syndrome

As we have seen, the type of symptoms will largely depend on the substance, the degree of dependence on it and even the biological characteristics of the dependent person. Below are some of the more well-known withdrawal syndromes from those listed by the DSM-5.

1. Tobacco

The withdrawal syndrome caused by tobacco is probably one of the best known and experienced worldwide, being the cessation of its consumption something that many consumers have considered. Irritability, insomnia, anxiety, concentration problems, depression and eating disorders are its main symptoms. It is annoying, but it is one of the least harmful withdrawal syndromes and is usually not dangerous.

• Related article: "The two faces of tobacco dependence (chemical and psychological)"

2. Alcohol

Chronic alcohol users who stop using this substance may experience different types of withdrawal syndromes of varying severity. Frequent symptoms are tachycardia and sweating, insomnia, hand tremoryes, agitation and anxiety, hallucinations Y seizures. In extreme cases, the subject may develop delirium tremens, which can lead to death.

3. Of stimulants

Within this category we include amphetamines, cocaine, and other stimulants. Withdrawal from these substances generates dysphoric mood, increased appetite, fatigue, nightmares and sleep problems as some of the more well-known symptoms.

4. Of sedatives, hypnotics and anxiolytics

The use and dosage and following the recommended consumption and withdrawal guidelines avoid this type of withdrawal syndrome, which can occur both in those who use them therapeutically and in those who do it recreationally and / or without control when consumption is withdrawn at once. Tremors, hyperactivity of the autonomic nervous system, tachycardia, nausea and vomiting, hallucinations, agitation and anxiety are some of the most typical symptoms.

5. Of opiates

The sudden withdrawal of opium and its derivatives (such as heroin) creates a withdrawal syndrome with the potential to be fatal. Dysphoria, nausea, pain, diarrhea, fever, insomnia or popular procrastination are some of the common symptoms in subjects with withdrawal from opium derivatives.

6. Cannabis

Cannabis is a substance whose consumption is very popular, especially among young people, and which is perceived as generally innocuous. However, the existence of a withdrawal syndrome has recently been described that can occur in subjects who consume daily or almost daily. This syndrome is characterized by restlessness, depression, loss of appetite, nervousness, and restlessness, and sometimes alterations such as fever, spasms, abdominal pain, or headache may arise.

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7. Caffeine

Although many people may argue with it, prolonged and daily frequent caffeine consumption It can generate a certain level of dependence on this substance, as well as withdrawal symptoms upon cessation abrupt. Fatigue and sleepiness, headache, flu symptoms, irritability or dysphoria are typical symptoms of this syndrome.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.