This is an unofficial archive of PsychonautWiki as of 2025-08-08T03:33:20Z. Content on this page may be outdated, incomplete, or inaccurate. Please refer to the original page for the most up-to-date information.
Substance withdrawal: Difference between revisions
>Clandestine DXM is *not* an opioid agonist in humans. This is dangerous misinformation! |
>David Hedlund {{#set:Featured=true}} |
||
| (7 intermediate revisions by 3 users not shown) | |||
| Line 3: | Line 3: | ||
Each substance causes its own specific symptoms with opioid withdrawals causing significantly different symptoms than benzodiazepine withdrawal, for instance. The term "[[cold turkey]]" is used to describe the sudden cessation use of a substance and the ensuing physiologic manifestations. It is recommended that users [[tapering|taper their dose]] slowly over time instead of abruptly stopping, which is associated with higher rates of relapse.{{opinion}}{{citation needed}} | Each substance causes its own specific symptoms with opioid withdrawals causing significantly different symptoms than benzodiazepine withdrawal, for instance. The term "[[cold turkey]]" is used to describe the sudden cessation use of a substance and the ensuing physiologic manifestations. It is recommended that users [[tapering|taper their dose]] slowly over time instead of abruptly stopping, which is associated with higher rates of relapse.{{opinion}}{{citation needed}} | ||
<span style="color:red"><b>Death can occur from the withdrawal of [[GABA#GABA receptors|GABAergic substances]] such as [[benzodiazepines]], [[thienodiazepines]], [[alcohol]], or [[barbiturates]], so [[tapering]] is especially recommended for these substances, ideally under medical supervision.</b></span><ref>A case of | <span style="color:red"><b>Death can occur from the withdrawal of [[GABA#GABA receptors|GABAergic substances]] such as [[benzodiazepines]], [[thienodiazepines]], [[alcohol]], or [[barbiturates]], so [[tapering]] is especially recommended for these substances, ideally under medical supervision.</b></span><ref>{{cite journal | vauthors=((Lann, M. A.)), ((Molina, D. K.)) | journal=The American Journal of Forensic Medicine and Pathology | title=A fatal case of benzodiazepine withdrawal | volume=30 | issue=2 | pages=177–179 | date= June 2009 | issn=1533-404X | doi=10.1097/PAF.0b013e3181875aa0}}</ref><ref>{{cite journal | vauthors=((Mirijello, A.)), ((D’Angelo, C.)), ((Ferrulli, A.)), ((Vassallo, G.)), ((Antonelli, M.)), ((Caputo, F.)), ((Leggio, L.)), ((Gasbarrini, A.)), ((Addolorato, G.)) | journal=Drugs | title=IDENTIFICATION AND MANAGEMENT OF ALCOHOL WITHDRAWAL SYNDROME | volume=75 | issue=4 | pages=353–365 | date= March 2015 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978420/ | issn=0012-6667 | doi=10.1007/s40265-015-0358-1}}</ref><ref>{{cite journal | vauthors=((Sarrecchia, C.)), ((Sordillo, P.)), ((Conte, G.)), ((Rocchi, G.)) | journal=Annali Italiani Di Medicina Interna: Organo Ufficiale Della Societa Italiana Di Medicina Interna | title=[Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication] | volume=13 | issue=4 | pages=237–239 | date= December 1998 | issn=0393-9340}}</ref> | ||
==Opioid withdrawal== | ==Opioid withdrawal== | ||
| Line 20: | Line 20: | ||
* '''[[Motivation suppression]]''' | * '''[[Motivation suppression]]''' | ||
* '''[[Appetite suppression]]''' | * '''[[Appetite suppression]]''' | ||
* '''[[Depression]]''' - This effect should be monitored closely as it can lead to suicidal idealizations<ref>Opiate and opioid withdrawal | * '''[[Depression]]''' - This effect should be monitored closely as it can lead to suicidal idealizations<ref name="Medlineplus949">{{Citation | title=Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia | url=https://medlineplus.gov/ency/article/000949.htm}}</ref> | ||
* '''[[Diarrhea]]''' | * '''[[Diarrhea]]''' | ||
* '''[[Dehydration]]''' | * '''[[Dehydration]]''' | ||
| Line 30: | Line 30: | ||
* '''[[Excessive yawning]]''' | * '''[[Excessive yawning]]''' | ||
* '''[[Tactile hallucinations|Skin crawling]]''' - This is distinct from the goosebumps experienced in withdrawal because the skin crawling sensation feels like something is distinctly moving under the skin. | * '''[[Tactile hallucinations|Skin crawling]]''' - This is distinct from the goosebumps experienced in withdrawal because the skin crawling sensation feels like something is distinctly moving under the skin. | ||
* '''[[Goosebumps]]''' - These are raised areas on the skin<ref> | * '''[[Goosebumps]]''' - These are raised areas on the skin<ref>{{Citation | title=goosebumps | url=https://dictionary.cambridge.org/us/dictionary/english/goosebumps}}</ref> that can appear and disappear suddenly. | ||
* '''[[Increased perspiration|Sweating]]''' | * '''[[Increased perspiration|Sweating]]''' | ||
* '''[[Pupil dilation|Dilated pupils]]''' - These are a stark contrast to the constricted pupils one sees in active opiate abusers and can be a hallmark of late stage opiate withdrawal.<ref | * '''[[Pupil dilation|Dilated pupils]]''' - These are a stark contrast to the constricted pupils one sees in active opiate abusers and can be a hallmark of late stage opiate withdrawal.<ref name="Medlineplus949"/> | ||
}} | }} | ||
| Line 49: | Line 49: | ||
==Alcohol withdrawal== | ==Alcohol withdrawal== | ||
The withdrawal symptoms of alcohol occur six hours after the abrupt discontinuation of extended alcohol usage. They are at their worst between 24 and 72 hours and improvement typically occurs by the seventh day.<ref name="emergency">Simpson, | The withdrawal symptoms of alcohol occur six hours after the abrupt discontinuation of extended alcohol usage. They are at their worst between 24 and 72 hours and improvement typically occurs by the seventh day.<ref name="emergency">{{cite journal | vauthors=((Simpson, S. A.)), ((Wilson, M. P.)), ((Nordstrom, K.)) | journal=The Journal of Emergency Medicine | title=Psychiatric Emergencies for Clinicians: Emergency Department Management of Alcohol Withdrawal | volume=51 | issue=3 | pages=269–273 | date= September 2016 | url=https://linkinghub.elsevier.com/retrieve/pii/S0736467916300282 | issn=07364679 | doi=10.1016/j.jemermed.2016.03.027}}</ref> The mechanism which underlies this process involves a decrease responsiveness of [[GABA]] receptors in the brain. | ||
'''Due to the risk of seizures or [[delirium tremens]], alcohol withdrawal can be fatal depending on the severity of usage.''' It is recommended to [[taper]] one's dosage and to seek medical attention and begin treatment as soon as possible. | '''Due to the risk of seizures or [[delirium tremens]], alcohol withdrawal can be fatal depending on the severity of usage.''' It is recommended to [[taper]] one's dosage and to seek medical attention and begin treatment as soon as possible. | ||
| Line 58: | Line 58: | ||
*'''[[Fever]]''' | *'''[[Fever]]''' | ||
*'''[[Tremors]]'''<ref name="emergency"></ref> | *'''[[Tremors]]'''<ref name="emergency"></ref> | ||
*'''[[Seizures]]'''<ref name="emergency"></ref> - In severe cases, this can result in death. Seizures typically occur within 48 hours of the abrupt discontinuation of alcohol and occur either as a single generalized tonic-clonic seizure or as a brief episode of multiple seizures.<ref>Manasco, A | *'''[[Seizures]]'''<ref name="emergency"></ref> - In severe cases, this can result in death. Seizures typically occur within 48 hours of the abrupt discontinuation of alcohol and occur either as a single generalized tonic-clonic seizure or as a brief episode of multiple seizures.<ref>{{cite journal | vauthors=((Manasco, A.)), ((Chang, S.)), ((Larriviere, J.)), ((Hamm, L. L.)), ((Glass, M.)) | journal=Southern Medical Journal | title=Alcohol withdrawal | volume=105 | issue=11 | pages=607–612 | date= November 2012 | issn=1541-8243 | doi=10.1097/SMJ.0b013e31826efb2d}}</ref> | ||
*'''[[External hallucinations]]'''<ref name="emergency"></ref> | *'''[[External hallucinations]]'''<ref name="emergency"></ref> | ||
*'''[[Auditory hallucination|Auditory hallucinations]]'''<ref name="emergency"></ref> | *'''[[Auditory hallucination|Auditory hallucinations]]'''<ref name="emergency"></ref> | ||
| Line 64: | Line 64: | ||
*'''[[Increased heart rate]]'''<ref name="emergency"></ref> | *'''[[Increased heart rate]]'''<ref name="emergency"></ref> | ||
*'''[[Irritability]]''' | *'''[[Irritability]]''' | ||
*'''[[Delirium tremens]]''' - This is the rapid onset of [[delirium]], [[confusion]], hallucinations, and other [[Delirium tremens#Subjective effects|symptoms]] associated with [[alcohol]] [[withdrawal]] caused by the abrupt discontinuation in long-term/heavy users. Delirium tremens are a cluster of symptoms, which can be potentially fatal. Delirium tremens usually occur three days after discontinuation and can last up to three days. It is reported that they are characteristically worse at night. '''Anyone thought to be suffering from the condition requires ''immediate medical intervention'' due to the risk of death, with the mortality without treatment being between 15% and 40%.'''<ref>Blom, | *'''[[Delirium tremens]]''' - This is the rapid onset of [[delirium]], [[confusion]], hallucinations, and other [[Delirium tremens#Subjective effects|symptoms]] associated with [[alcohol]] [[withdrawal]] caused by the abrupt discontinuation in long-term/heavy users. Delirium tremens are a cluster of symptoms, which can be potentially fatal. Delirium tremens usually occur three days after discontinuation and can last up to three days. It is reported that they are characteristically worse at night. '''Anyone thought to be suffering from the condition requires ''immediate medical intervention'' due to the risk of death, with the mortality without treatment being between 15% and 40%.'''<ref>{{cite book | vauthors=((Blom, J. D.)) | date=8 December 2009 | title=A Dictionary of Hallucinations | publisher=Springer Science & Business Media | isbn=9781441912237}}</ref> | ||
*'''[[Increased blood pressure]]'''<ref name="emergency"></ref> | *'''[[Increased blood pressure]]'''<ref name="emergency"></ref> | ||
*'''[[Dream potentiation]]''' - For many individuals this can often lead to particularly unsettling, scary and abnormally vivid dreams or nightmares. | *'''[[Dream potentiation]]''' - For many individuals this can often lead to particularly unsettling, scary and abnormally vivid dreams or nightmares. | ||
| Line 73: | Line 73: | ||
*'''[[Increased perspiration]]''' | *'''[[Increased perspiration]]''' | ||
*'''[[Nausea]]'''<ref name="emergency"></ref> | *'''[[Nausea]]'''<ref name="emergency"></ref> | ||
*'''[[Wernicke syndrome]]''' - This is condition characterized by extreme confusion, an abnormal gait, and the paralysis of muscles in the eye. This condition occurs only in severe alcohol withdrawal cases. Wernicke syndrome can progress into irreversible dementia so anyone suspected of this should seek immediate medical attention and be treated with 100mg of thiamine daily while withdrawling.<ref name=" | *'''[[Wernicke syndrome]]''' - This is condition characterized by extreme confusion, an abnormal gait, and the paralysis of muscles in the eye. This condition occurs only in severe alcohol withdrawal cases. Wernicke syndrome can progress into irreversible dementia so anyone suspected of this should seek immediate medical attention and be treated with 100mg of thiamine daily while withdrawling.<ref name="Myrick1998">{{cite journal | vauthors=((Myrick, H.)), ((Anton, R. F.)) | journal=Alcohol Health and Research World | title=Treatment of Alcohol Withdrawal | volume=22 | issue=1 | pages=38–43 | date= 1998 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761817/ | issn=0090-838X}}</ref> | ||
===Treatment=== | ===Treatment=== | ||
*'''[[tapering|Gradually tapering one's intake]]''' - Withdrawal symptoms can be reduced by slowly lowering one's dosage over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. It is inadvisable to self-administer a taper; the remaining alcohol should be given to a trusted friend or family member and distributed by only them. | *'''[[tapering|Gradually tapering one's intake]]''' - Withdrawal symptoms can be reduced by slowly lowering one's dosage over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. It is inadvisable to self-administer a taper; the remaining alcohol should be given to a trusted friend or family member and distributed by only them. | ||
*'''[[Benzodiazepines]]''' - Benzodiazepines (such as [[diazepam]], [[lorazepam]], [[chlordiazepoxide]], and [[oxazepam]]) are the most common treatment for alcohol withdrawal.<ref>Stern, | *'''[[Benzodiazepines]]''' - Benzodiazepines (such as [[diazepam]], [[lorazepam]], [[chlordiazepoxide]], and [[oxazepam]]) are the most common treatment for alcohol withdrawal.<ref>{{cite journal | vauthors=((Stern, T. A.)), ((Gross, A. F.)), ((Stern, T. W.)), ((Nejad, S. H.)), ((Maldonado, J. R.)) | journal=Primary Care Companion to the Journal of Clinical Psychiatry | title=Current approaches to the recognition and treatment of alcohol withdrawal and delirium tremens: “old wine in new bottles” or “new wine in old bottles” | volume=12 | issue=3 | pages=PCC.10r00991 | date= 2010 | issn=1555-211X | doi=10.4088/PCC.10r00991ecr}}</ref> However, benzodiazepines have a [[Benzodiazepine#Tolerance and addiction potential|high risk of addiction]], so one should be careful not to become physically dependent on them. | ||
*'''Vitamins''' such as '''thiamine'''<ref name="one">Recognition and management of withdrawal delirium (delirium tremens) | *'''Vitamins''' such as '''thiamine'''<ref name="one">{{cite journal | vauthors=((Schuckit, M. A.)) | journal=The New England Journal of Medicine | title=Recognition and management of withdrawal delirium (delirium tremens) | volume=371 | issue=22 | pages=2109–2113 | date=27 November 2014 | issn=1533-4406 | doi=10.1056/NEJMra1407298}}</ref>, '''folic acid''', and '''pyridoxine''' - These vitamins are often recommended because those dependent on alcohol are often deficient in nutrients; in very severe cases, this can result in [[Wernicke syndrome]], which is a condition characterized by extreme [[confusion]], an abnormal gait, and the paralysis of muscles in the eye. Wernicke syndrome can progress into irreversible dementia so anyone suspected of this should seek immediate medical attention and be treated with 100mg of thiamine daily while withdrawling. | ||
*'''Magnesium''' - Although it has not been verified, there may be a causal relationship between low magnesium levels and withdrawal seizures or delirium.<ref name=" | *'''Magnesium''' - Although it has not been verified, there may be a causal relationship between low magnesium levels and withdrawal seizures or delirium.<ref name="Myrick1998"/> | ||
*'''[[Anticonvulsants]]''' such as '''[[topiramate]]''', '''[[pregabalin]]''', or '''[[gabapentin]]''' - There is some limited evidence that topiramate, pregabalin, or gabapentin could help alcohol withdrawal; however, gabapentin is not recommended for severe withdrawal.<ref>Hammond, | *'''[[Anticonvulsants]]''' such as '''[[topiramate]]''', '''[[pregabalin]]''', or '''[[gabapentin]]''' - There is some limited evidence that topiramate, pregabalin, or gabapentin could help alcohol withdrawal; however, gabapentin is not recommended for severe withdrawal.<ref>{{cite journal | vauthors=((Hammond, C. J.)), ((Niciu, M. J.)), ((Drew, S.)), ((Arias, A. J.)) | journal=CNS drugs | title=Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders | volume=29 | issue=4 | pages=293–311 | date= April 2015 | issn=1179-1934 | doi=10.1007/s40263-015-0240-4}}</ref><ref>{{cite journal | vauthors=((Leung, J. G.)), ((Hall-Flavin, D.)), ((Nelson, S.)), ((Schmidt, K. A.)), ((Schak, K. M.)) | journal=The Annals of Pharmacotherapy | title=The role of gabapentin in the management of alcohol withdrawal and dependence | volume=49 | issue=8 | pages=897–906 | date= August 2015 | issn=1542-6270 | doi=10.1177/1060028015585849}}</ref> | ||
*'''[[Haloperidol]]''' - The antipsychotic haloperidol may also be used to control symptoms, especially agitation or psychosis. However, antipsychotics lower the seizure threshold so they can potentially worsen the withdrawal. | *'''[[Haloperidol]]''' - The antipsychotic haloperidol may also be used to control symptoms, especially agitation or psychosis. However, antipsychotics lower the seizure threshold so they can potentially worsen the withdrawal. | ||
*'''Paraldehyde''' - This is an older medication that is generally not used anymore. In regards to treating severe and fatal withdrawal symptoms, paraldehyde combined with chloral hydrate showed superior results over chlordiazepoxide.<ref>Minozzi, S. | *'''Paraldehyde''' - This is an older medication that is generally not used anymore. In regards to treating severe and fatal withdrawal symptoms, paraldehyde combined with chloral hydrate showed superior results over chlordiazepoxide.<ref>{{cite journal | vauthors=((Minozzi, S.)), ((Amato, L.)), ((Vecchi, S.)), ((Davoli, M.)) | veditors=((Cochrane Drugs and Alcohol Group)) | journal=Cochrane Database of Systematic Reviews | title=Anticonvulsants for alcohol withdrawal | date=17 March 2010 | url=https://doi.wiley.com/10.1002/14651858.CD005064.pub3 | issn=14651858 | doi=10.1002/14651858.CD005064.pub3}}</ref> | ||
*'''Acamprosate''' - This substance is sometimes used in addition to other treatments. It can be continued long-term to reduce the risk of relapse. | *'''Acamprosate''' - This substance is sometimes used in addition to other treatments. It can be continued long-term to reduce the risk of relapse. | ||
*'''Carbamazepine''' - This substance assisted in the reduction of withdrawal symptoms in seven scientific trials involving 612 patients.<ref name=" | *'''Carbamazepine''' - This substance assisted in the reduction of withdrawal symptoms in seven scientific trials involving 612 patients.<ref name="Myrick1998"/></ref> However, it is questionable whether or not the substance can prevent seizures and delirium tremens in a similar manner to benzodiazepines due to inconclusive evidence. | ||
*'''[[Clonidine]]''' - This substance is sometimes combined with benzodiazepines to treat symptoms. | *'''[[Clonidine]]''' - This substance is sometimes combined with benzodiazepines to treat symptoms. | ||
| Line 107: | Line 107: | ||
*'''[[tapering|Gradually tapering one's intake]]''' - Withdrawal symptoms can be reduced by slowly lowering one's intake of nicotine over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. This may be very difficult for some individuals and many prefer to quit [[cold turkey]]. | *'''[[tapering|Gradually tapering one's intake]]''' - Withdrawal symptoms can be reduced by slowly lowering one's intake of nicotine over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. This may be very difficult for some individuals and many prefer to quit [[cold turkey]]. | ||
*'''[[Nicotine replacement therapy]]''' - This stops withdrawal symptoms by providing the body with an alternative source of nicotine. NRT is available in numerous forms and includes nicotine chewing gum, adhesive patches, lozenges, and nasal sprays.<ref>Nicotine (Drugs.com) | https://www.drugs.com/monograph/nicotine.html</ref> Combining different forms is shown to be more effective than only using one form.<ref name="updates">Update on medicines for smoking cessation | *'''[[Nicotine replacement therapy]]''' - This stops withdrawal symptoms by providing the body with an alternative source of nicotine. NRT is available in numerous forms and includes nicotine chewing gum, adhesive patches, lozenges, and nasal sprays.<ref>Nicotine (Drugs.com) | https://www.drugs.com/monograph/nicotine.html</ref> Combining different forms is shown to be more effective than only using one form.<ref name="updates">{{cite journal | vauthors=((McDonough, M.)) | journal=Australian Prescriber | title=Update on medicines for smoking cessation | volume=38 | issue=4 | pages=106–111 | date= August 2015 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653977/ | issn=0312-8008 | doi=10.18773/austprescr.2015.038}}</ref><ref>{{cite journal | vauthors=((Cahill, K.)), ((Stevens, S.)), ((Perera, R.)), ((Lancaster, T.)) | journal=The Cochrane Database of Systematic Reviews | title=Pharmacological interventions for smoking cessation: an overview and network meta-analysis | issue=5 | pages=CD009329 | date=31 May 2013 | issn=1469-493X | doi=10.1002/14651858.CD009329.pub2}}</ref> Generally, the user is encouraged to later [[tapering|taper]] one's new nicotine intake after several weeks. | ||
*'''[[Bupropion]]''' (Wellbutrin) - This is a medication primarily used as an antidepressant and smoking cessation aid, reducing the intensity of nicotine cravings and its withdrawal symptoms. It acts as a nicotinic acetylcholine receptor antagonist as well as a noradrenaline-dopamine reuptake inhibitor (NDRI). It doubles the chance of quitting smoking successfully, making its effectiveness comparable to nicotine replacement therapy but less effective than varenicline.<ref>Effectiveness of smoking cessation therapies: a systematic review and meta-analysis | *'''[[Bupropion]]''' (Wellbutrin) - This is a medication primarily used as an antidepressant and smoking cessation aid, reducing the intensity of nicotine cravings and its withdrawal symptoms. It acts as a nicotinic acetylcholine receptor antagonist as well as a noradrenaline-dopamine reuptake inhibitor (NDRI). It doubles the chance of quitting smoking successfully, making its effectiveness comparable to nicotine replacement therapy but less effective than varenicline.<ref>{{cite journal | vauthors=((Wu, P.)), ((Wilson, K.)), ((Dimoulas, P.)), ((Mills, E. J.)) | journal=BMC public health | title=Effectiveness of smoking cessation therapies: a systematic review and meta-analysis | volume=6 | pages=300 | date=11 December 2006 | issn=1471-2458 | doi=10.1186/1471-2458-6-300}}</ref> | ||
*'''Varenicline''' (Chantix) - This prescription medication is a nicotinic receptor partial agonist which is similar to [[cytisine]] and works to reduce cravings by stimulating nicotine receptors more weakly than nicotine itself does. It also decreases the euphoric effects of cigarettes and other nicotine products. | *'''Varenicline''' (Chantix) - This prescription medication is a nicotinic receptor partial agonist which is similar to [[cytisine]] and works to reduce cravings by stimulating nicotine receptors more weakly than nicotine itself does. It also decreases the euphoric effects of cigarettes and other nicotine products. | ||
*'''Cytisine''' - This substance is a partial agonist of nicotinic acetylcholine receptors (nAChRs), which is similar to varenicline. | *'''Cytisine''' - This substance is a partial agonist of nicotinic acetylcholine receptors (nAChRs), which is similar to varenicline. | ||
| Line 164: | Line 164: | ||
* '''[[Tachycardia]]''' | * '''[[Tachycardia]]''' | ||
* '''[[Tinnitus]]''' | * '''[[Tinnitus]]''' | ||
* '''[[Catatonia]]''' - This may result in death.<ref> Rosebush, | * '''[[Catatonia]]''' - This may result in death.<ref>{{cite journal | vauthors=((Rosebush, P. I.)), ((Mazurek, M. F.)) | journal=Journal of Clinical Psychopharmacology | title=Catatonia after benzodiazepine withdrawal | volume=16 | issue=4 | pages=315–319 | date= August 1996 | issn=0271-0749 | doi=10.1097/00004714-199608000-00007}}</ref> | ||
* '''[[Confusion]]''' | * '''[[Confusion]]''' | ||
* '''[[Seizure]]s''' - This may result in death.<ref> Haque, W | * '''[[Seizure]]s''' - This may result in death.<ref>{{cite journal | vauthors=((Haque, W.)), ((Watson, D. J.)), ((Bryant, S. G.)) | journal=Texas Medicine | title=Death following suspected alprazolam withdrawal seizures: a case report | volume=86 | issue=1 | pages=44–47 | date= January 1990 | issn=0040-4470}}</ref> | ||
* '''Coma''' (rare) | * '''Coma''' (rare) | ||
* '''[[Delirium tremens]]''' | * '''[[Delirium tremens]]''' | ||
| Line 181: | Line 181: | ||
*'''[[Tapering]]''' - Withdrawal symptoms can be reduced by slowly lowering one's dosage over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. It is inadvisable to self-administer a taper; the remaining substance should be given to a trusted friend or family member and distributed by only them. | *'''[[Tapering]]''' - Withdrawal symptoms can be reduced by slowly lowering one's dosage over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. It is inadvisable to self-administer a taper; the remaining substance should be given to a trusted friend or family member and distributed by only them. | ||
*'''[[Gabapentin]]''' or '''[[pregabalin]]''' | *'''[[Gabapentin]]''' or '''[[pregabalin]]''' | ||
*'''[[Baclofen]]'''<ref>Baclofen in the short-term maintenance treatment of benzodiazepine dependence | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271384/</ref> | *'''[[Baclofen]]'''<ref>{{cite journal | vauthors=((Shukla, L.)), ((Kandasamy, A.)), ((Kesavan, M.)), ((Benegal, V.)) | journal=Journal of Neurosciences in Rural Practice | title=Baclofen in the short-term maintenance treatment of benzodiazepine dependence | volume=5 | issue=Suppl 1 | pages=S53–S54 | date= November 2014 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271384/ | issn=0976-3147 | doi=10.4103/0976-3147.145203}}</ref> | ||
*'''[[Phenibut]]''' - Switching to another [[GABAergic]] can lessen the perceived symptoms, but is likely to also prolong the period of withdrawal and could potentially lead to addiction. | *'''[[Phenibut]]''' - Switching to another [[GABAergic]] can lessen the perceived symptoms, but is likely to also prolong the period of withdrawal and could potentially lead to addiction. | ||
*'''[[L-Theanine]]''' | *'''[[L-Theanine]]''' | ||
| Line 187: | Line 187: | ||
*'''[[Valerian root]]''' | *'''[[Valerian root]]''' | ||
*'''[[GABA]]''' - Although GABA may not cross the blood-brain barrier, there are some reports of this supplement helping withdrawal. | *'''[[GABA]]''' - Although GABA may not cross the blood-brain barrier, there are some reports of this supplement helping withdrawal. | ||
*'''[[Magnesium]]'''<ref>alpha-beta L-aspartate magnesium in treatment of chronic benzodiazepine abuse: controlled and double-blind study versus placebo] | *'''[[Magnesium]]'''<ref>{{cite journal | vauthors=((Hantouche, E. G.)), ((Guelfi, J. D.)), ((Comet, D.)) | journal=L’Encephale | title=[alpha-beta L-aspartate magnesium in treatment of chronic benzodiazepine abuse: controlled and double-blind study versus placebo] | volume=24 | issue=5 | pages=469–479 | date= October 1998 | issn=0013-7006}}</ref> | ||
*'''[[Flumazenil]]''' | *'''[[Flumazenil]]''' | ||
| Line 242: | Line 242: | ||
*'''[[tapering|Gradually tapering one's intake]]''' - Withdrawal symptoms can be reduced by slowly lowering one's dosage over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. It is inadvisable to self-administer a taper; the remaining substance should be given to a trusted friend or family member and distributed by only them. | *'''[[tapering|Gradually tapering one's intake]]''' - Withdrawal symptoms can be reduced by slowly lowering one's dosage over a period of days or weeks, which will let receptors recover somewhat before complete discontinuation. This will lessen the severity of symptoms but likely prolong their duration. It is inadvisable to self-administer a taper; the remaining substance should be given to a trusted friend or family member and distributed by only them. | ||
*'''Dronabinol''' - Dronabinol is an agonist that is legally available; in some cases and trials, it reduced symptoms of withdrawal and reduced cannabis use.<ref name="two">State of the Art Treatments for Cannabis Dependence | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371269/</ref> | *'''Dronabinol''' - Dronabinol is an agonist that is legally available; in some cases and trials, it reduced symptoms of withdrawal and reduced cannabis use.<ref name="two">{{cite journal | vauthors=((Danovitch, I.)), ((Gorelick, D. A.)) | journal=The Psychiatric Clinics of North America | title=State of the Art Treatments for Cannabis Dependence | volume=35 | issue=2 | pages=309–326 | date= June 2012 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371269/ | issn=0193-953X | doi=10.1016/j.psc.2012.03.003}}</ref> | ||
*'''[[Diphenhydramine]]''' (DPH) - This substance can assist with sleep if one has insomnia, but may also exacerbate the [[restlessness]] of withdrawal in high does. | *'''[[Diphenhydramine]]''' (DPH) - This substance can assist with sleep if one has insomnia, but may also exacerbate the [[restlessness]] of withdrawal in high does. | ||
*'''[[Benzodiazepines]]''' - As benzodiazepines have a high risk of addiction, one should be careful not to become physically dependent on them. | *'''[[Benzodiazepines]]''' - As benzodiazepines have a high risk of addiction, one should be careful not to become physically dependent on them. | ||
*'''Exercise''' - This may reduce some symptoms and accelerates the rate that THC exits the body by releasing the THC metabolites stored in the fat tissue into the blood stream<ref> | *'''Exercise''' - This may reduce some symptoms and accelerates the rate that THC exits the body by releasing the THC metabolites stored in the fat tissue into the blood stream<ref>{{cite journal | vauthors=((Gunasekaran, N.)), ((Long, L.)), ((Dawson, B.)), ((Hansen, G.)), ((Richardson, D.)), ((Li, K.)), ((Arnold, J.)), ((McGregor, I.)) | journal=British Journal of Pharmacology | title=Reintoxication: the release of fat-stored Δ9-tetrahydrocannabinol (THC) into blood is enhanced by food deprivation or ACTH exposure | volume=158 | issue=5 | pages=1330–1337 | date= November 2009 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782342/ | issn=0007-1188 | doi=10.1111/j.1476-5381.2009.00399.x}}</ref>. | ||
*'''[[N-Acetylcysteine]] (NAC)''' - In terms of reducing cravings, NAC has been shown to provide relief for those who struggle with compulsive redosing and psychological cravings with cocaine, and has been singled out with gabapentin as a promising potential treatment for cannabis-dependent users.<ref>Echevarria, M. A. | *'''[[N-Acetylcysteine]] (NAC)''' - In terms of reducing cravings, NAC has been shown to provide relief for those who struggle with compulsive redosing and psychological cravings with cocaine, and has been singled out with gabapentin as a promising potential treatment for cannabis-dependent users.<ref>{{cite journal | vauthors=((Nocito Echevarria, M. A.)), ((Andrade Reis, T.)), ((Ruffo Capatti, G.)), ((Siciliano Soares, V.)), ((Silveira, D. X. da)), ((Fidalgo, T. M.)) | journal=Psychiatry Research | title=N-acetylcysteine for treating cocaine addiction – A systematic review | volume=251 | pages=197–203 | date= May 2017 | url=https://linkinghub.elsevier.com/retrieve/pii/S0165178116308861 | issn=01651781 | doi=10.1016/j.psychres.2017.02.024}}</ref><ref>{{cite journal | vauthors=((Sherman, B. J.)), ((McRae-Clark, A. L.)) | journal=Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy | title=Treatment of Cannabis Use Disorder: Current Science and Future Outlook | volume=36 | issue=5 | pages=511–535 | date= May 2016 | url=https://onlinelibrary.wiley.com/doi/10.1002/phar.1747 | issn=02770008 | doi=10.1002/phar.1747}}</ref> | ||
*'''Magnesium''' - Magnesium supplementation can be used to help treat some of the anxiety of cannabis withdrawal as well as the potential mental and physical restlessness that often accompanies it.{{citation needed}} | *'''Magnesium''' - Magnesium supplementation can be used to help treat some of the anxiety of cannabis withdrawal as well as the potential mental and physical restlessness that often accompanies it.{{citation needed}} | ||
*'''[[Gabapentin]]''' - Early, preliminary evidence suggests that gabapentin is capable of reducing withdrawal symptoms and relapse rates in [[cannabis]]-dependent adults who seek to quit. However, larger confirmatory studies are still required.<ref>Mason, B. J., Crean, R., Goodell, V., Light, J. M., Quello, S., Shadan, F., ... | *'''[[Gabapentin]]''' - Early, preliminary evidence suggests that gabapentin is capable of reducing withdrawal symptoms and relapse rates in [[cannabis]]-dependent adults who seek to quit. However, larger confirmatory studies are still required.<ref>{{cite journal | vauthors=((Mason, B. J.)), ((Crean, R.)), ((Goodell, V.)), ((Light, J. M.)), ((Quello, S.)), ((Shadan, F.)), ((Buffkins, K.)), ((Kyle, M.)), ((Adusumalli, M.)), ((Begovic, A.)), ((Rao, S.)) | journal=Neuropsychopharmacology | title=A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults | volume=37 | issue=7 | pages=1689–1698 | date= June 2012 | url=http://www.nature.com/articles/npp201214 | issn=0893-133X | doi=10.1038/npp.2012.14}}</ref> | ||
*'''Acetaminophen''' (paracetamol) - Acetaminophen (paracetamol) may help with withdrawal due to one of its metabolites being a cannabinoid (CB<sub>1</sub>) agonist.{{citation needed}} | *'''Acetaminophen''' (paracetamol) - Acetaminophen (paracetamol) may help with withdrawal due to one of its metabolites being a cannabinoid (CB<sub>1</sub>) agonist.{{citation needed}} | ||
==Caffeine withdrawal== | ==Caffeine withdrawal== | ||
Research has suggested that withdrawals start between 12 to 24 hours after the abrupt discontinuation of caffeine and may last up to nine days.<ref> | Research has suggested that withdrawals start between 12 to 24 hours after the abrupt discontinuation of caffeine and may last up to nine days.<ref>{{cite journal | vauthors=((Juliano, L. M.)), ((Griffiths, R. R.)) | journal=Psychopharmacology | title=A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features | volume=176 | issue=1 | pages=1–29 | date= October 2004 | issn=0033-3158 | doi=10.1007/s00213-004-2000-x}}</ref> | ||
Caffeine dependence can involve withdrawal symptoms such as: | Caffeine dependence can involve withdrawal symptoms such as: | ||
*'''[[Headaches]]''' - In one study, it was found that headaches were experienced by half of the participants who stopped consuming 235mg of caffeine on average daily for two days.<ref>Withdrawal syndrome after the double-blind cessation of caffeine consumption | *'''[[Headaches]]''' - In one study, it was found that headaches were experienced by half of the participants who stopped consuming 235mg of caffeine on average daily for two days.<ref>{{cite journal | vauthors=((Silverman, K.)), ((Evans, S. M.)), ((Strain, E. C.)), ((Griffiths, R. R.)) | journal=The New England Journal of Medicine | title=Withdrawal syndrome after the double-blind cessation of caffeine consumption | volume=327 | issue=16 | pages=1109–1114 | date=15 October 1992 | issn=0028-4793 | doi=10.1056/NEJM199210153271601}}</ref> | ||
*'''[[Physical fatigue]]<ref name="caffe">Juliano, L. M., | *'''[[Physical fatigue]]<ref name="caffe">J{{cite journal | vauthors=((Juliano, L. M.)), ((Griffiths, R. R.)) | journal=Psychopharmacology | title=A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features | volume=176 | issue=1 | pages=1–29 | date= October 2004 | url=http://link.springer.com/10.1007/s00213-004-2000-x | issn=0033-3158 | doi=10.1007/s00213-004-2000-x}}</ref>''' | ||
*'''[[Decreased energy]]'''<ref name="caffe"></ref> | *'''[[Decreased energy]]'''<ref name="caffe"></ref> | ||
*'''[[Depression]]'''<ref name="caffe"></ref> | *'''[[Depression]]'''<ref name="caffe"></ref> | ||
| Line 306: | Line 306: | ||
[[Category:Responsible drug use]] | [[Category:Responsible drug use]] | ||
{{#set:Featured=true}} | |||