How Long Does Withdrawal from Drugs and Alcohol Last?

Acute Withdrawal Phase

The initial withdrawal period is often the most intense. This acute phase is when the body is suddenly deprived of the substances it has grown dependent on. The duration and severity of acute withdrawal largely depends on the drug of abuse:

• Alcohol - Alcohol withdrawal symptoms tend to peak within 24-72 hours after the last drink. Delirium tremens, the most dangerous symptom, typically begins 2-4 days after cessation. Acute withdrawal usually resolves within 5-7 days.

• Benzodiazepines - Acute withdrawal from benzodiazepines can begin within 6-12 hours. Symptoms often peak in intensity during the second week and can last for several months in chronic users. The protracted withdrawal syndrome can persist for over a year.

• Opiates - The acute opiate withdrawal phase usually starts within 6-12 hours of last use. Symptoms tend to peak within 1-3 days and gradually improve over 5-7 days.

• Stimulants - Cocaine withdrawal symptoms begin quickly once the drug leaves the system, crashing within 1-3 days. Withdrawal from methamphetamine peaks around 2-4 days out but insomnia and fatigue may linger for a week or more.

Acute opioid, alcohol and benzodiazepine withdrawal can potentially be life-threatening without proper medical care. Medications, tapering, hydration and nutritional support help manage symptoms in a safe detox environment.

PAWS - Post-Acute Withdrawal Syndrome

After getting through the worst of acute withdrawal, many people experience a drawn-out process of recovery known as post-acute withdrawal syndrome (PAWS). PAWS can begin after the initial withdrawal phase or even months into sobriety.

These protracted withdrawal symptoms are primarily psychological in nature, including:

• Mood swings
• Insomnia
• Fatigue
• Impaired concentration
• Cravings

PAWS can be loosely defined as withdrawal that extends beyond the typical timeframe, persisting weeks to years after the acute phase. This ongoing symptomology illustrates that brain chemistry continues normalizing well after drug cessation.

PAWS Duration by Substance

The longevity and severity of PAWS depends heavily on which substance is involved:

• Alcohol - PAWS from alcohol may come and go over 6 months to 2 years or more. Psychological symptoms and some mild deficits in executive functioning can continue improving for a year or longer.
• Benzodiazepines - Due to their rapid onset and addictive nature, benzodiazepine withdrawal often extends for over a year. Lingering PAWS has been reported for 3 years or more by long-term users.
• Opiates - Studies show at least 3 months of protracted symptoms is common when withdrawing from opiates like heroin or prescription painkillers. Many continue feeling PAWS effects periodically for 6 months to 1 year.
• Stimulants - Cocaine withdrawal PAWS can fluctuate in severity for months at a time. Methamphetamine withdrawal may include fatigue, increased appetite and depression for up to one year.

Post-acute withdrawal does not follow a linear path. Symptoms tend to come and go like waves, gradually decreasing in severity and duration. Support groups help people overcome PAWS and solidify recovery during this drawn-out period.

Factors That Influence Withdrawal Duration

While there are general timelines for withdrawal from various substances, it remains a highly individual experience. Several factors play a role in determining how long withdrawal takes:

Severity of Addiction

People diagnosed with severe substance use disorder often have a harder time withdrawing. The longer and more intensely someone has engaged in drug or alcohol abuse, the longer it generally takes their brain and body to recover. Using high doses makes the process even more drawn-out and intense.

Co-occurring Disorders

Mental health conditions like depression, trauma or anxiety disorders tend to complicate withdrawal. Psychological symptoms of PAWS may be amplified due to an underlying condition. Dual diagnosis treatment helps stabilize mental illness during early recovery.

Physical Health

Poor health can make withdrawal more dangerous and prolonged. Medical detox provides 24/7 monitoring and medications to stabilize individuals with health issues. Nutrition, hydration, electrolytes and other supports also minimize withdrawal severity.

Genetic Variables

Research shows that genetics account for about 50% of a persons addiction vulnerability. Inherited traits likely also play a role in how the brain and body handle withdrawal. No definitive genetic markers have been identified yet.

Polydrug Abuse

Withdrawing from multiple substances concurrently tends to lengthen the overall process. Each drugs unique withdrawal timeline must run its course. Recovering polydrug users also face higher risks of relapse and post-acute withdrawal.

Managing Protracted Withdrawal Symptoms

Since PAWS can produce symptoms sporadically for months to years, effective coping strategies are key. Some tips for managing protracted withdrawal include:

• Get plenty of rest - Fatigue is very common during PAWS.
• Eat healthy foods - Nutrition supports brain healing and reduces cravings.
• Stay hydrated - Dehydration exacerbates withdrawal side effects.
• Exercise - Naturally boosts mood and relieves stress.
• Reduce workload - Take time to stabilize without undue stress.
• Attend support groups - 12-step programs help normalize PAWS.
• Practice relaxation techniques - Yoga, mindfulness, deep breathing.
• Avoid drug triggers - Spend time in sober places with clean friends.
• Use medications appropriately - Consult a doctor about reducing/stopping medications.
• Get therapy for co-occurring disorders - Treat underlying psychiatric issues simultaneously.

While PAWS can be discouraging, its persistence does not mean treatment has failed. The brain simply needs ample time to re-adjust its reward circuitry after dependency. Embracing healthy lifestyle changes and ongoing therapy keeps people progressing through this drawn-out recovery stage.

How Long Does Drug Withdrawal Last?

In summary, the overall duration of withdrawal can range from weeks to years depending on:

• Type of substance abused
• Level of dependence
• Presence of co-occurring disorders
• Physical health status
• Genetic variables
• Polydrug use

Acute withdrawal marks the initial intense phase lasting about 1-14 days depending on the drug. Post-acute withdrawal syndrome then sets in, creating psychological and physiological symptoms that may persist for many months. Support and patience are required while the brain fully resets and repairs itself after dependency.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.