Comprehensive guide to drug withdrawal symptoms

Key signs to look out for when withdrawing from an addictive drug.

Further reading: Signs and symptoms Addiction assessment Detox Rehab Aftercare Statistics

Page last updated: Friday, 6 September 2024

Clinically reviewed by: Claire Rimmer

Lead Addiction Therapist at Priory Hospital Altrincham in Manchester

Understanding drug withdrawal symptoms is crucial for anyone who wants to stop their substance use. This is because withdrawal is often a difficult process and can even be dangerous.

Learn about the symptoms of drug withdrawal so that you can keep yourself and others safe, plus find out what help and support is available for people who want to stop using drugs.

Understanding drug withdrawal

When you take drugs, your brain and body adapt to having these substances in your system. Over time, this can lead to you becoming dependent on these drugs in order to function. Your tolerance may also increase, meaning that you need to take more of the drug to get the same effects as when you began using the drug.

Your brain is altered by drug use, too. Many drugs cause artificially elevated neurotransmitter levels and when the drug is no longer in a person’s system, these neurotransmitter levels drop suddenly. Withdrawal symptoms then occur as the brain struggles to re-establish normal neurotransmitter levels.

Stopping or significantly reducing your use of the drug can cause a range of unpleasant and sometimes dangerous symptoms. This is known as drug withdrawal.

Different drugs can cause different withdrawal symptoms. Most cause intense cravings for the drug, alongside other unpleasant effects, including both physical and psychological symptoms.

Common symptoms of drug withdrawal

Drug withdrawal often causes a combination of physical and psychological symptoms.

Nausea and vomiting
Headaches
High temperature and/or chills
Heart palpitations
Excessive sweating
Shaking and shivering

Depression
Anxiety
Paranoia
Insomnia
Panic attacks
Irritability and agitation
Intense cravings for the drug

The most severe drug addiction withdrawal symptoms are known as ‘delirium tremens’ (DTs). Symptoms include:

Visual and/or auditory hallucinations
Seizures

These symptoms need proper management and medical attention, as they can result in serious long-term complications and can even be life-threatening.

Here are some withdrawal symptoms of addictive drugs:

Cannabis: sleep problems, strange dreams, anxiety and restlessness, irritability and anger, sweats and chills, changes in your appetite, nicotine withdrawal (if you smoke cannabis with tobacco)
Cocaine: feeling anxious or depressed, being tired, issues with sleep, feeling paranoid, struggling to concentrate
Prescription drugs: headaches, muscle tension, irritability and anxiety, muscle aches, diarrhoea and vomiting
Crack cocaine: restlessness, muscle aches, depression, anxiety, changes in appetite, fatigue, nightmares
Heroin: shaking, sweating, aches and pains, stomach problems, nausea or vomiting, sleep disturbances, increased heart rate or blood pressure

Duration and initial signs of withdrawal

The drug withdrawal timeline is different for everyone, but often the first sign is experiencing a drug comedown. This is when the initial effects of the drug begin to wear off and your brain chemistry gradually returns to normal. The initial symptoms of a drug comedown include nausea, exhaustion, headaches and diarrhoea.

Find out how to manage a comedown.

If you don’t take any more drugs following the initial comedown, you’ll eventually start to experience drug withdrawal.

Withdrawal symptoms typically begin within 24 hours of taking the drug, and are worst for the first 48 hours. DTs may develop 48 to 72 hours after your drug use stops. You may find that symptoms change as withdrawal progresses, but they'll gradually improve as your body adapts to being without the drug. The entire withdrawal process usually lasts between 7 and 10 days.

How long withdrawal symptoms last will vary according to the type of drug used. For example:

Short-acting opioids, for example, heroin and prescription painkillers

Onset of withdrawal: 8 to 24 hours after last use

Length of withdrawal: 4 to 10 days

Common symptoms:

- Nausea and vomiting
- Anxiety
- Insomnia
- Hot and cold flushes
- Perspiration
- Muscle cramps
- Watery discharge from eyes and nose
- Diarrhoea

Longer-acting opioids, for example, methadone

Onset of withdrawal: 2 to 4 days after last use

Length of withdrawal: Up to 10 days

Common symptoms:

- Nausea and vomiting
- Anxiety
- Insomnia
- Hot and cold flashes
- Perspiration
- Muscle cramps
- Watery discharge from eyes and nose
- Diarrhoea

Benzodiazepines, for example, Valium

Onset of withdrawal: 1 to 4 days after last use

Length of withdrawal: Peaks in intensity within first 2 weeks. Withdrawal symptoms can last for 12 months in 10 to 25% of users

Common symptoms:

- Sleep disturbances
- Irritability
- Increased tension and anxiety
- Panic attacks
- Hand tremors
- Sweating
- Difficulty in concentration
- Dry retching and nausea
- Possible weight loss
- Palpitations
- Headaches
- Muscular pain and stiffness

Cannabis

Onset of withdrawal: 24 to 72 hours after last use

Length of withdrawal: 1 to 2 weeks

Common symptoms:

- Anxiety
- Irritability
- Anger or aggression
- Disturbed sleep/dreaming
- Depressed mood and loss of appetite
- Chills
- Headaches
- Physical tension
- Sweating
- Stomach pain

Factors affecting duration and severity

Some withdrawal effects may persist for longer, however. When a substance breaks down in the body, it forms metabolites. Cannabis metabolites, for example, accumulate in body fat and may take weeks to leave the body completely, depending on your genetic make-up and physical health.

Long-acting benzodiazepines can stay active in your system for a while after you’ve stopped taking them, which prolongs the withdrawal process. In some cases, certain withdrawal symptoms may persist for months, or even years without treatment.

Why symptoms vary from person-to-person

Many factors can affect the nature and severity of drug withdrawal symptoms, including:

Duration: prolonged use leads to greater physical and psychological dependence, so if you've been addicted to the drug for a long period of time, your withdrawal symptoms may be worse
Drug: some drugs cause more intense withdrawal symptoms than others due to their specific effects on the brain's neurotransmitter systems, how quickly they create dependence, and the severity of the body's adaptation to their presence
Quantity: taking larger quantities of drugs can cause more severe withdrawal symptoms
Method: snorting, smoking and injecting drugs usually result in more acute withdrawal symptoms than if you take drugs orally because these methods deliver the drug to the brain more quickly and intensely
Mixing drugs: taking multiple types of drugs can cause more severe symptoms
Genetics: your family history and genetic make-up can affect your tolerance to drugs
Health: poor general physical health can weaken the body's ability to cope with withdrawal stress and exacerbate emotional and psychological challenges. Drug use can also mask other issues such as malnutrition, disease, chronic pain, infections (common in intravenous drug use) or sleep deprivation

Managing withdrawal symptoms safely

If you're ready to stop using drugs and break free from your physical and mental dependence, seeking professional help is crucial during the withdrawal process. Without expert support, managing your withdrawal symptoms can become overwhelming and potentially dangerous. Withdrawal can also be risky, so it's essential to have a qualified multidisciplinary team of mental health professionals ensuring your safety throughout the process.

At Priory, we offer a medically assisted drug detox as a standalone service or as part of a broader private drug rehab programme. This detoxification process removes all traces of the drug from your body in a controlled, clinical setting under the supervision of our medical professionals. We provide medication and necessary medical interventions to help ease any withdrawal symptoms, ensuring a safe and comfortable experience.

Compassionate and supportive care is just as important as medication in the drug detox process. This is why we’re dedicated to providing exceptional support to our detox clients, 24 hours a day, 7 days a week.

Once you’ve safely completed detox and are physically stable, the next step may be to begin therapy – depending on your individual needs and the treatment programme you’re on. If you’re continuing into one of our structured addiction programmes, you’ll take part in intensive group therapy designed to help you build healthy coping strategies, explore the underlying causes of your addiction and move forward with confidence. If you’ve chosen detox as a standalone option, we’ll support you in planning your next steps so you can continue your recovery in a way that’s right for you.

Free drug detox programmes may also be available in the UK. Speak to your GP about what’s available to you, or refer to Mind’s list of support organisations for drug addiction to find a service in your community.

You don't have to face drug addiction and withdrawal alone. Expert support is available. Contact Priory today to learn how we can help you safely overcome drug dependence and begin a life free from addiction.