Drug withdrawal syndrome: its types and symptoms.

Symptoms that appear when drugs such as heroin or tobacco are suddenly stopped.

It is common to hear the expression "going cold turkey" when talking about drug-dependent people who are experiencing tremors, nervousness or outbursts of anger at a time when drugs are not available.

These are situations in which these people are suffering greatly and experiencing variable symptomatology. This is a colloquial way of speaking of the withdrawal syndrome, a problem we are going to talk about in this article..

What is the withdrawal syndrome?

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

Withdrawal is usually caused intentionally by the dependent subject, in order to eliminate the aversive consequences that the addiction is causing in his or her life. They can also occur due to involuntary circumstances in which it is not possible to access the substance in question, such as hospitalization, travel or incarceration. A third option is that the subject is unable to acquire it despite being unwilling to stop consumption, due to a lack of suppliers or the economic capacity to acquire it.

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

The evolution of the symptomatology and its 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 itself, the problems associated with withdrawal syndrome will intensify if the cessation of drug use occurs in an environment where it is easy to acquire it. Also the way of seeing the world or of perceiving and facing the problems are going to have an effect, having greater discomfort for example inhibited people who do not express their feelings (especially the negative ones).

Why does it occur?

The reason for the withdrawal syndrome is something that many people, especially those who suffer from it, wonder. The direct reason is the sudden cessation or reduction of consumptionThe direct reason is the sudden cessation or reduction of consumption, which has taken place 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 to increase in quantity and frequency) and the body becomes accustomed to functioning 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, eventually loses part of this role and becomes necessary to avoid the discomfort associated with its lack.

An abrupt withdrawal causes the organism, which was dependent on this substance, to suddenly find itself lacking something that made it function. The internal equilibrium or homeostasis that the body had learned to maintain with the drug is suddenly unbalanced. The internal equilibrium or homeostasis that the body had learned to maintain with the drug is suddenly thrown out of balance, generating withdrawal symptoms until it can maintain equilibrium on its own. But depending on how the withdrawal is done, the imbalance can generate very severe repercussions.

The need for gradual withdrawal

It is important to keep in mind that the withdrawal of the substance should not be done suddenly. Although the cessation of consumption in drug addicts is essential and something that can save their lives (both figuratively and literally), suddenly cutting off the supply of a substance on which our body is dependent can have fatal consequences. Withdrawal is no laughing matter: it is a dangerous reality that in many cases can have permanent consequences, lead to coma and even death..

In this regard, the type of drug must be taken into account: getting off coffee is not the same as getting off cocaine or heroin.. It also depends on the level of dependence. Withdrawal is necessary, but it must be done in a controlled (e.g. different drugs are often used), gradual and controlled manner to avoid severe physiological effects and reduce the risk of a life-threatening withdrawal syndrome.

It is necessary to allow the body to become accustomed to functioning without so many substances until it is able to function completely without them. Occasionally, the use of substitute substances may be necessary to reduce the risk of life-threatening withdrawal. Sometimes the use of substitute substances, such as methadone, may be necessary.such as methadone, as long as the substance consumption does not occur but dangerous symptoms are kept at bay, or hospitalization in detoxification centers or hospitalization of the subject to keep him/her stabilized. In some cases, a subject has even been put into an induced coma to gain better control of the situation.

Alcohol, benzodiazepines and opiates are some of the main substances with potentially life-threatening withdrawal syndromes, mostly due to cardiorespiratory failure.. Therefore, it is necessary to prescribe their withdrawal.

Different types of withdrawal syndromes

As we have seen, the type of symptoms will depend to a large extent on the substance, the degree of dependence on it and even the Biological characteristics of the dependent person. Below are some of the best known withdrawal syndromes among those included in 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, etc. and eating disorders are its main symptoms. It is annoying, but it is one of the least harmful withdrawal syndromes and is not usually dangerous.

2. Of alcohol

Chronic alcohol users who stop consuming alcohol may experience different types of withdrawal syndromes of varying severity. Frequent symptoms are tachycardia and sweating, insomnia, hand tremors, agitation and anxiety, anxiety and anxiety, and anxiety about the use of alcohol.agitation and anxiety, hallucinations and convulsions. In extreme cases it is possible for the subject to 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 best known symptoms.

4. Of sedatives, hypnotics and anxiolytics

The use and dosage of sedatives, hypnotics and anxiolytics 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 use them recreationally. in those who use them therapeutically as well as in those who use them recreationally and/or uncontrollably when the drug is withdrawn. and/or uncontrolled when consumption is suddenly withdrawn. 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) generates a withdrawal syndrome with the potential to be fatal. Dysphoria, nausea, pain, diarrhea, fever, insomnia or popular dilation are some of the usual symptoms in subjects with withdrawal to opium derivatives.

6. Cannabis

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

7. Caffeine

Although many people may dispute it, the frequent consumption of caffeine on a prolonged and daily basis can generate a certain level of dependence to this substance, as well as withdrawal syndrome with its abrupt cessation. Fatigue and sleepiness, headache, flu-like symptoms, irritability or dysphoria are typical symptoms of such a syndrome.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.