Withdrawal can undoubtedly be the ugliest part of the addiction and recovery cycle. It can be emotionally and physically excruciating for the individual experiencing it. However, even for loved ones, it can be just as challenging and heartbreaking to watch.
Fortunately, most withdrawal processes are not life-threatening. With appropriate supervision and monitoring, peak symptoms often decrease within a few days. Let’s get into the essential do’s and don’ts for supporting someone experiencing withdrawal.
Learn About What To Expect During Withdrawal
Chronic drug use leads to tolerance. Tolerance refers to needing to take more of the drug to achieve the intended or desired effects. When someone builds a tolerance to a particular substance, they experience withdrawal once abstaining from it. Because the body has depended on the substance for its daily functioning, it attempts to restore balance once it is out of the system.
The withdrawal process looks different for everyone. Symptoms can range from mildly distressing to severely life-threatening, and the severity of such symptoms depends on a variety of factors including:
- Type of drug(s) used
- Frequency, intensity, and duration of drug use
- History of withdrawal processes in the past
- Co-occurring mental illness
- Demographic details (age, sex, additional physical conditions)
Alcohol is the most abused drug in the world. Alcohol withdrawal symptoms may include:
- Headaches and migraines
- Nausea and vomiting
- Insomnia and other sleep problems
- Psychotic symptoms (confusion, hallucinations, delusions)
- Shaky hands
- Delirium tremens (the most severe type of psychotic symptoms)
Alcohol withdrawal symptoms can start as early as 6 hours after the last drink. The first symptoms tend to be mild, but the most serious symptoms peak within 2-3 days.
In their prescribed form, opioids like Percocet or Oxycodone can help treat acute and chronic pain. However, some opioids (such as heroin) can also be taken illicitly and abused. Opioid withdrawal symptoms may include:
- Heightened pain sensations
- Muscle and bone pain
- Flu-like symptoms (runny nose, sweating, flushed skin)
- Gastrointestinal distress
- Insomnia and other sleep problems
- Nausea and vomiting
Opioid withdrawal can start as early as 6-12 hours for short-acting opioids. The harshest symptoms tend to peak within 72 days, but they begin subsiding shortly afterward.
Stimulants impact the body’s central nervous center, and the psychological distress associated with withdrawal tends to be far more threatening than the physical symptoms. Stimulant withdrawal symptoms may include:
- Anhedonia (loss of pleasure or interest in usual activities)
- Intensified feelings of paranoia and anxiety
- Fatigue and oversleeping
- Increased appetite
- Memory problems
- Psychotic symptoms (hallucinations and delusions)
Stimulant withdrawal tends to emerge anywhere between just a few hours to several days after the last drug use. Intense symptoms peak around a week, although some symptoms can persist for several weeks or months after quitting.
Benzodiazepines are tranquilizers and sedatives often prescribed for anxiety, seizures, and insomnia. Xanax, Ativan, Klonopin, and Valium are all common benzodiazepines. Withdrawal symptoms may include:
- Increased anxiety or panic attacks
- Excessive sweating
- Heart palpitations
- Headaches and migraines
- Muscle stiffness and pain
- Psychotic symptoms
Symptoms start within about 6-12 hours after the last dose, peaking around the second week of abstinence. They begin to subside shortly after that, although some symptoms may persist for several weeks or months.
Encourage Professional Treatment
Most experts advise against any at-home detox processes. The cold-turkey approach inherently has many risks. For example, detoxing from some substances (like alcohol or benzodiazepines) can result in fatal seizures. Most relatives and friends are simply unequipped to treat these issues should they arise.
Likewise, all withdrawal processes can lead to psychiatric or medical complications. Someone who struggles with depression may start to experience severe suicidal ideation. Someone with a history of psychotic symptoms may have dangerous hallucinations that can lead to him hurting himself or other people. Failing to address these can result in physical or emotional problems, which can also exacerbate the risk for relapse.
Furthermore, withdrawal tends to be very uncomfortable. To avoid this discomfort, many people return to drug use. Most loved ones do not have the training to support someone experiencing such intense cravings and desire to use. Instead, they often feel powerless and helpless in aiding the detoxing individual.
Medical detox treatment, on the other hand, provides both structure and accountability. Professionals are available 24/7 to provide support and encouragement during this process. They also offer complete monitoring if any concerning symptoms emerge.
Provide Support and Validation
In addition to the physical discomfort, withdrawal can feel incredibly isolating and shameful. You don’t have to understand the symptoms first-hand to provide compassion,
Support doesn’t need to be overly complicated. You just need to focus on how you can encourage your loved one to keep going. This could entail you reminding them how proud you are of their hard work. It could also include you recognizing and acknowledging the pain and misery they’re experiencing.
To put it simply, during withdrawal, focus on how you can be your loved one’s cheerleader. The more you can stay positive, the more likely you are to influence their attitude!
Uphold Your Boundaries
Unfortunately, many people relapse during or just after their withdrawal process. You must know that relapse isn’t a sign of failure. Your loved one may not be ready for such a serious change. They may not have adequate coping skills for managing the distress associated with early sobriety.
Addiction is a chronic disease, and relapse can undoubtedly be a part of recovery. However, it is essential that you identify and uphold your boundaries during this time. Boundaries are, of course, personal, but they may include:
- Refusing to provide financial resources or support
- Prohibiting your loved one from staying or visiting your home
- Denying requests to bail your loved one out of jail or provide other legal support
- Refusing criticism, name-calling, or other related insults
- Refusing to lie, omit, or otherwise “cover-up” drug-related activity
Remember that you’re allowed to change and update your boundaries whenever you need. However, you also must know that boundaries are only as good as your willingness to enforce them! Saying that you are going to do something- without following through- only creates more potential for manipulation.
Do Not Bring Up All Their Wrongdoings
If your loved one has hurt you in the past, you may feel tempted to “let them have it” while they’re withdrawing. After all, this is a good time to face the consequences of their actions, right?
As it turns out, such confrontation is rarely- if ever- appropriate during the withdrawal stage. It’s like kicking someone when they’re already down on the ground. At this time, the individual is not physically or emotionally equipped to cope with the ramifications of what you need to share. Furthermore, they cannot justifiably commit to “making it right” in this state of mind.
By dredging up the past, you risk exacerbating feelings of guilt, shame, and humiliation. In doing this, you may actually trigger your loved one back into drug use!
Of course, you are entitled to your feelings and experiences. Just remember there are a time and place to share these with your loved one. Acute distress is not the best occasion.
Do Not Give Them Money or Drugs To “Get Well”
As mentioned, it’s painful to watch someone you love struggle with drug withdrawal. Because it can be so painful, many goodhearted people offer money or drugs (often at their loved one’s insistence). Many people engage in this very act while transporting their loved one to a professional detox facility!
This enabling only perpetuates the perils of addiction. Individuals must be held accountable for their decisions. By offering them money or drugs, you are becoming part of the problem. Like it or not, you are essentially encouraging drug use!
Do Not Take Things Too Personally
People can say and do awful things when they’re in withdrawal. While you deserve to be treated with respect and compassion, you should also be mindful and avoid taking everything your loved one says at face value. When we’re in pain, we tend to be irrational and illogical. Unfortunately, we also tend to be most spiteful to the people we love the most.
To put this into context, would you want to be held responsible for what you say during one of the most physically uncomfortable experiences of your life? Probably not!
It’s not easy- or even enjoyable- to support someone going through withdrawal. However, you can be a valuable asset in helping your loved one locate the professional support they need during this vulnerable time.
At Stepping Stone Center for Recovery, we are available 24/7 to help you and your loved one on the road towards recovery. Contact us today to speak to our admissions team.