By David Joel Miller.
You’re more likely to have a drug withdrawal than you might think.
When people think of drug withdrawal the picture they see is the one of classic heroin withdrawal. Someone coming off heroin or other opiates does some “kicking” both drug wise and legs-wise. They also have diarrhea and “goose bumps.” Because opiates are pain relievers during withdrawals people can experience high levels of pain.
That dramatic type of withdrawal is not the only kind you might have. Each drug you might take can have some effects when the level in your body, principally in your bloodstream, begins to drop.
Drug Withdrawal Defined.
Drug withdrawal is an identifiable illness or syndrome that happens when someone stops taking a drug or reduces the amount they are using significantly. The symptoms begin when the level of a drug in the blood drops. Withdrawal symptoms can vary in severity and each drug has its own pattern of withdrawal symptoms. An alternative name for withdrawal is Abstinence Syndrome.
In the early stages of drug use, withdrawal symptoms may be minimal and go unnoticed. Once the body has adjusted to having that drug present and made adaptations the symptoms become more pronounced. Symptoms may not be entirely physical. For some drugs the primary withdrawal symptoms are psychological.
Withdrawal symptoms make it harder to stop using drugs.
The more severe the withdrawal symptoms the more likely the user is to pick that drug back up to reduce those symptoms. A withdrawal symptom of drugs taken to reduce anxiety, prescribed or self-medicated ones, is an increase in anxiety. People who smoke marijuana to reduce anxiety report that the anxiety gets really bad after they discontinue smoking it. This results in a return to marijuana use.
Getting rid of withdrawal symptoms is a strong motivator to resume drug use again.
The DSM-5 lists withdrawal effects for eight of the eleven classes of substances.
I find it interesting that some drugs such as Inhalants and Hallucinogens have no withdrawal symptoms specified. We also have only one diagnosis and F code for the group of drugs, Sedative, Hypnotic or Anxiolytic Drugs. Withdrawal from these drugs can be different with different drugs. Stimulant Withdrawal is separated and has one code for Cocaine and another for Amphetamines and other stimulants. These DSM-5 codes are a rough sketch. For the full details consult the DSM-5 text. Also, note that there are well-defined withdrawal criteria for Cannabis (Marijuana) and Caffeine.
Alcohol Withdrawal (F10.239 or F10.232)
Caffeine Withdrawal (F15.93)
Cannabis (Marijuana) Withdrawal (F12.288)
Opioid Withdrawal (F11.23)
Sedative, Hypnotic or Anxiolytic Withdrawal (F13.239, F13.232)
Amphetamine or other stimulant (F15.23)
Cocaine Withdrawal (F14.23)
Tobacco Withdrawal (F17.203)
Other (or Unknown) Substance Withdrawal (F19.239)
For more on drugs and recovery see:
Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
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