Everything You Need to Know About Drug and Alcohol Withdrawal

Alcohol and drug withdrawal can be a frightening experience, but it’s often a necessary part of the addiction recovery process. Knowing what to expect during withdrawal can help to limit the stress surrounding it.

What is Acute Withdrawal?

After someone stops or significantly decreases their use of a psychoactive substance, the body goes into acute withdrawal, also known as post-acute withdrawal syndrome. The signs and symptoms associated with acute withdrawal vary by person and physiology. Acute withdrawal can last anywhere from days to weeks, depending on the substance(s) used.

What is Protracted Withdrawal?

In some cases, the symptoms of acute withdrawal can last for months or even years, even though the body has healed from physical side effects. This is known as protracted withdrawal and can be a very difficult experience especially when in the early stages of recovery. Protracted withdrawal is more common with certain substances like alcohol and benzodiazepines (e.g., Xanax, Valium, Ativan) and in individuals who abused substances for longer period of time.

What to Expect During Alcohol Withdrawal

The specific symptoms of alcohol withdrawal depend on how much and how often someone drinks. For most people, the first step is to detox from alcohol which should be done under medical supervision because it can be a dangerous process. During alcohol detox, there are a few different stages that someone may go through.

Prodromal Stage

The first stage is known as the prodromal stage and typically lasts for 12-24 hours after the last drink. This stage is characterized by anxiety, agitation, insomnia, and flu-like symptoms.

Accelerative Stage

The second stage is known as the accelerative stage and lasts for 24-48 hours after the last drink. This stage is characterized by increased anxiety, agitation, and delirium.

Delirium Stage

The final stage is known as the delirium stage and typically lasts for 48-72 hours after the last drink. This stage is characterized by hallucinations, delusions, and severe confusion.

Protracted Alcohol Withdrawal

After someone has detoxed from alcohol, they may still experience some symptoms of withdrawal for weeks or even months. These symptoms, known as protracted withdrawal, can include anxiety, depression, insomnia, and irritability.

What to Expect During Drug Withdrawal

The specific symptoms of drug withdrawal depend on the substance(s) used, but there are common symptoms associated with all types of drug withdrawal. Generally, withdrawal symptoms can be divided into two categories: physical and psychological.

Physical Symptoms of Drug Withdrawal

Physical symptoms of drug withdrawal typically begin within hours or days after the last use of a substance. These symptoms can include:

  • Anxiety
  • Agitation
  • Insomnia
  • Flu-like symptoms
  • Nausea and vomiting
  • Sweating
  • Headaches
  • Diarrhea
  • Muscle aches and pains
  • Cramping
  • Increased heart rate and blood pressure

Psychological Symptoms of Drug Withdrawal

Psychological symptoms of drug withdrawal also begin within hours or days after the last use of a substance. These symptoms can include:

  • Anxiety
  • Depression
  • Irritability
  • Mood swings
  • Excessive tiredness
  • Agitation
  • Anger
  • Paranoia
  • Intense cravings for the substance(s) used

Management of Drug and Alcohol Withdrawal

Withdrawal from any substance can be a difficult and dangerous process, which is why it is best to treat and manage withdrawal under medical supervision. There are a few different treatment options medical professionals use to help ease the symptoms of withdrawal and make the process as comfortable as possible.


Medications can be used during the detox process. Some medications commonly used to help manage the symptoms of withdrawal include Buprenorphine, Disulfiram, Phenobarbital, specific benzodiazepines (e.g., Librium) and Naltrexone. These medications can be used to help with everything from acute anxiety and agitation to flu-like symptoms and muscle aches.

Individual Therapy

In addition to medication, individual therapy is also helpful in managing the symptoms of withdrawal. Therapy can help individuals address the underlying causes of their addiction as well as learn healthy coping strategies to better manage the psychological symptoms of withdrawal.

Support Groups and Group Therapy

Support groups and group therapy can also be a helpful resource for people during withdrawal. These groups provide a safe and supportive setting for people to share their experiences and learn from others going through the same thing.

Williamsville Wellness understands the importance of drug and alcohol withdrawal in the beginning stages of recovery. While we do not provide medical detox, we can recommend detox facilities in the area to attend prior to beginning our residential or outpatient treatment programs. Contact us today to begin your recovery journey in a safe, supportive environment with treatment fit to your individual needs.