8 Drug Withdrawal Symptoms (2027 Guide)

The physical and psychological reactions that appear when someone sharply cuts back or stops a substance their body has come to depend on are called drug withdrawal symptoms. Cravings, anxiety, broken sleep and nausea come up most, with the World Health Organization (WHO) adding vomiting and diarrhea to the symptoms common across drug types. Some withdrawal can be life-threatening. Stopping alcohol or benzodiazepines suddenly after heavy, regular use can trigger seizures, so medical advice before quitting matters. A seizure, hallucinations or sudden confusion call for 911 right away. 

Key Takeaways

• Only people who have become dependent on a substance go through withdrawal.
• Alcohol and benzodiazepine withdrawal can cause seizures, so stopping either after heavy use calls for medical supervision.
• Opioid withdrawal is rarely life-threatening by itself, yet the drop in tolerance afterwards makes a return to the old amount an overdose risk.
• Acute withdrawal lasts from about 3 days for stimulants to 8 weeks or longer for long-acting benzodiazepines.
• Thoughts of suicide during withdrawal need immediate help through 9-8-8 by phone or text, or 911 in an emergency.

What Is Drug Withdrawal?

According to the WHO, withdrawal management is the medical and psychological care of people whose symptoms start after they stop or reduce a drug they depend on. Regular use teaches the nervous system to function with the substance present, so tolerance builds as the same amount produces less effect. When the drug is taken away, the body stays set up for it for days or weeks, and the mismatch that follows is drug withdrawal.

Physical dependence can exist without addiction. The National Institute on Drug Abuse (NIDA) diagnoses a substance use disorder only when a person has two or more symptoms from a clinical list, with withdrawal as just one entry on it. Someone taking a prescribed benzodiazepine for several weeks can become physically dependent, the WHO notes, without the loss of control described in the signs of drug addiction.

Withdrawal usually reverses a drug's main effects, so the drug itself is the best clue to what withdrawal will involve. Alcohol, benzodiazepines, and opioids are depressants that slow the central nervous system. Stopping them brings anxiety and insomnia, plus a faster heart rate and higher blood pressure in the case of alcohol. Stimulants such as cocaine and methamphetamine speed the system up, so their absence leaves depression, long sleep and a bigger appetite.

8 Common Drug Withdrawal Symptoms

Most people going through withdrawal notice several of the symptoms of drug withdrawal below at once. Which ones dominate depends on the drug and on how severe the dependence has become. The list moves from cravings, which can persist for months, to tremor and a racing heart, which can signal an emergency within days.

Intense Cravings

Strong urges to use are among the psychological withdrawal symptoms that can outlast every physical one. NIDA counts a strong desire to use among the criteria for a substance use disorder. People who have just stopped can feel powerful cravings, and cues tied to past use, such as certain people, places and moods, can set off an urge long after the last dose.

For opioid and alcohol use disorders, NIDA reports that some medicines reduce cravings along with other withdrawal symptoms, making it easier to stop or cut back. If cravings do lead back to use, NIDA treats that return as a signal to speak with a healthcare provider about resuming or changing the treatment plan.

Anxiety and Irritability

Withdrawal anxiety can show up as a racing mind, trouble sitting still, or a sense of dread with no clear cause. In the WHO guideline, anxiety appears on the symptom lists for opioid, alcohol, benzodiazepine, and cannabis withdrawal. Agitation and irritability are listed for benzodiazepines and stimulants, with cannabis adding fear and a feeling of detachment.

A short temper and snapping at small requests are signs of drug withdrawal that family and coworkers can spot. For someone who took benzodiazepines to treat an anxiety disorder, the original symptoms are likely to return once the drug is gone, according to the WHO, and they deserve care of their own. Panic that does not settle needs urgent medical help, as does aggression or agitation combined with confusion or hallucinations.

Depression and Mood Swings

Low mood after stopping a drug ranges from flatness and lost interest in daily life to deep hopelessness. Stimulants are most closely tied to it, with depression named among the main symptoms of withdrawal from cocaine, amphetamine and methamphetamine. NIDA includes depression among the emotional symptoms people face when they first stop using drugs. Inhalant withdrawal can bring depressed mood too. During stimulant withdrawal, the WHO advises watching mental state closely for depression and anxiety.

Thoughts of suicide call for help right away. The 9-8-8 Suicide Crisis Helpline answers calls and texts 24 hours a day, 7 days a week, in English and French, according to the Public Health Agency of Canada. Anyone in immediate danger should call 911.

Sleep Problems

Depressants and stimulants push sleep in opposite directions. Insomnia is a listed symptom of opioid, alcohol and benzodiazepine withdrawal, with cannabis withdrawal disturbing sleep through vivid dreams for some people. After cocaine, amphetamine or methamphetamine, the reverse happens, and the WHO lists increased sleeping as a symptom.

Difficulty sleeping is one of the ten items on the WHO's Short Opioid Withdrawal Scale, so clinicians track it as a measure of how severe opioid withdrawal has become. Insomnia accompanied by hallucinations or disorientation after alcohol belongs to severe withdrawal and needs emergency care. Sleep disturbances are among the symptoms addiction treatment aims to relieve, NIDA says, with researchers studying medications for sleep problems linked to addiction.

Fatigue and Brain Fog

Heavy limbs, slow thinking, forgetfulness, and trouble following a conversation make up what people call brain fog. Broken sleep adds to the tiredness. NIDA also notes that brain circuits affected by long-term use need time to regain balance. Poor concentration and memory are listed for benzodiazepine withdrawal. People stopping inhalants feel lethargic during withdrawal, with confusion and difficulty concentrating that can last up to a month.

Long-term heavy drinking adds a separate risk to thinking and memory. To help prevent cognitive impairment, the WHO recommends vitamin B1 (thiamine) during alcohol withdrawal. Fog that turns into disorientation, where the person is unsure where they are, what time it is, or who is with them, marks severe alcohol withdrawal.

Nausea, Vomiting and Diarrhea

Stomach cramps, nausea, vomiting and loose stools rank among the most common physical withdrawal symptoms. They appear on the WHO lists for opioid and alcohol withdrawal, with gastrointestinal upset recorded after cannabis as well. Poor appetite, another cannabis withdrawal symptom, means less food and fluid going in at the same time.

Of all the stomach symptoms, fluid loss carries the greatest risk. Opioid withdrawal drains fluids through sweating and diarrhea, and dehydration is a listed symptom of alcohol withdrawal. In its extreme form, the WHO counts dehydration among the complications that can become life-threatening. Its guideline sets a daily fluid target for people in opioid, stimulant and alcohol withdrawal to replace what is lost. Being unable to keep fluids down, feeling faint on standing, or passing very little urine are reasons for same-day medical care.

Muscle Aches, Sweating and Chills

For many people, opioid withdrawal defines what withdrawal feels like, since the WHO compares it to a very bad flu. Hot and cold flushes, heavy sweating, muscle cramps, yawning, and a runny nose are the hallmarks. On the Short Opioid Withdrawal Scale, muscle spasms, muscular tension, aches and feeling cold are each rated from mild to severe.

For moderate to severe opioid withdrawal, the WHO guideline adds medication such as clonidine, which eases sweating, chills, cramps and several other physical symptoms. Clonidine can also cause dizziness and low blood pressure, so blood pressure is checked before each use.

Other drug classes produce some of the same complaints. Stimulant withdrawal brings muscle aches, benzodiazepine withdrawal brings muscle tension, and cannabis withdrawal can cause night sweats.

Tremors, Racing Heart and High Blood Pressure

Shaking hands, a pounding pulse and a rise in blood pressure are classic features of alcohol withdrawal, appearing alongside heavy sweating, nausea and insomnia. Benzodiazepine withdrawal produces a similar overactive pattern of restlessness, agitation and muscle tension. A mild tremor can also accompany cannabis withdrawal.

On the WHO scale for alcohol, tremor is scored from a slight shake in the hands to a constant marked tremor. The same scale gives its top temperature score to anything above 38.5°C, and clinicians repeat it every four hours for at least three days of alcohol withdrawal.

A seizure, hallucinations, confusion about time and place, or wide swings in body temperature during alcohol withdrawal are medical emergencies. So is any seizure after stopping benzodiazepines. Call 911.

Mild, Moderate and Severe Withdrawal

Clinicians grade withdrawal to match care to severity. In the WHO guideline, opioid and alcohol withdrawal are each rated on a scored checklist, with the total deciding how much medical care a person needs. On the opioid scale, 0 to 10 points count as mild withdrawal, 10 to 20 as moderate and 20 to 30 as severe. Alcohol uses its own bands of 1 to 4 for mild, 5 to 14 for moderate and 15 or more for severe.

Benzodiazepine withdrawal resists scoring because its intensity rises and falls from day to day. For this class, the guideline has a health worker ask the person about symptoms every 3 to 4 hours. For non-emergency advice, many provinces run a free 8-1-1 line staffed by registered nurses, as listed by Health Canada.

Level	What it can look like	What to do
Mild	Restlessness, poor sleep, low appetite, cravings, mild nausea	Rest, fluids and a call to a family doctor, pharmacist or provincial 8-1-1 line
Moderate	Repeated vomiting or diarrhea, visible tremor, heavy sweating, racing heart, panic	Same-day medical assessment and a conversation about medically supervised withdrawal
Severe	Seizures, hallucinations, confusion about time or place, extreme agitation, thoughts of suicide	Call 911 now; for suicidal thoughts without immediate danger, call or text 9-8-8

How Long Do Drug Withdrawal Symptoms Last?

The WHO sets out how long withdrawal lasts for each drug class, with these ranges for the acute phase.

• Short-acting opioids such as heroin start 8 to 24 hours after last use and last 4 to 10 days.
• Long-acting opioids such as methadone start 12 to 48 hours after last use, with symptoms lasting 10 to 20 days.
• Stimulant withdrawal from cocaine or methamphetamine begins within 24 hours and runs 3 to 5 days.
• Alcohol withdrawal appears 6 to 24 hours after the last drink and lasts 2 to 10 days.
• Short-acting benzodiazepines produce symptoms 1 to 2 days after the last dose, lasting 2 to 4 weeks or longer.
• Long-acting benzodiazepines can take 2 to 7 days to bring on symptoms, which then last 2 to 8 weeks or longer.
• Cannabis withdrawal lasts 1 to 2 weeks.

A drug's duration of action explains most of the spread. Short-acting drugs bring withdrawal on earlier and end it sooner, a pattern visible in the WHO ranges for both opioids and benzodiazepines. For people stopping alcohol, the 36 to 72 hour mark is the stretch of the alcohol withdrawal timeline when symptoms are at their worst.

Acute symptoms can give way to a quieter phase that lasts much longer. After opioids, the WHO describes a protracted stretch of up to six months marked by reduced well-being and strong cravings. Stimulants leave a phase of one to two months with tiredness, anxiety, unstable mood and erratic sleep. Clinicians sometimes call this later period post-acute withdrawal syndrome (PAWS). For opioids, the cravings of this phase lead many people back to use.

When Drug Withdrawal Becomes Dangerous

With alcohol and benzodiazepines withdrawal can kill. Opioids carry a separate risk that appears after withdrawal ends.

Life-threatening alcohol withdrawal is rare, the WHO explains. When it happens, the complications are seizures, hallucinations, delirium, extreme swings in body temperature and blood pressure, and extreme agitation. Stopping benzodiazepines abruptly can cause seizures, which is why the same guideline calls a gradual reduction the safest way to stop them. Any reduction plan belongs with a doctor.

With opioids, the greatest danger comes after the symptoms fade. Anyone who has completed opioid withdrawal faces a higher risk of overdose because tolerance has dropped, the WHO warns. NIDA explains that using the amount taken before quitting can cause a life-threatening overdose. Opioids, alcohol and benzodiazepines all appear among the hardest drugs to quit, with the medical danger of their withdrawal as part of the reason. 

Among people who used large amounts of stimulants, methamphetamine above all, some experience paranoia, disordered thinking and hallucinations. They may become a danger to themselves or others, though these symptoms usually clear within a week of stopping.

Call 911 if the person:

• has a seizure
• sees or hears what is not there, or does not know where they are
• is extremely agitated or threatening to hurt themselves or someone else
• has a very high temperature, heavy sweating, and shaking after stopping alcohol
• is hard to wake or breathing slowly after using again
• has thoughts of suicide and is in immediate danger

For suicidal thoughts without immediate danger, 9-8-8 is available by call or text. Calling 911 during an overdose comes with some legal protection under the Good Samaritan Drug Overdose Act, which covers the caller, the person overdosing, and anyone still at the scene when help arrives, according to Health Canada. It shields them from charges for simple possession under section 4(1) of the Controlled Drugs and Substances Act, as well as from breaches of conditions tied to simple possession. Trafficking and outstanding warrants fall outside it. 

Withdrawal Symptoms by Substance

Several prescription medicines in the table cause withdrawal or discontinuation symptoms when stopped suddenly, among them gabapentin, ADHD stimulants and the antidepressants venlafaxine, bupropion and fluoxetine. A change to any prescribed medicine should be planned with the prescriber. Medication support also differs by substance. NIDA reports approved medications for opioid and alcohol use disorders but none yet for stimulants or cannabis, so withdrawal from cocaine, crack or cannabis is managed with supportive care and relief of individual symptoms.

Substance	Typical signs	Main risk
Alcohol	Tremor, sweating, insomnia	Seizures and delirium
Benzodiazepines	Anxiety, insomnia, poor concentration	Seizures if stopped suddenly
Opioids	Flu-like aches, diarrhea, sweating	Overdose after tolerance drops
Cocaine	Low mood, fatigue, cravings	Severe depression
Crack	Exhaustion, irritability, intense cravings	Paranoia after heavy use
Cannabis	Irritability, poor sleep, vivid dreams	Worsening anxiety
Ketamine	Cravings, low mood, fatigue	Relapse
Gabapentin	Anxiety, sweating, insomnia	Seizures if stopped abruptly
Kratom	Muscle aches, irritability, runny nose	Relapse
ADHD stimulants	Fatigue, low mood, bigger appetite	Depression
Antidepressants (venlafaxine)	Dizziness, nausea, shock-like sensations	Return of depression
Antidepressants (bupropion)	Irritability, headache, low mood	Return of depression
Antidepressants (fluoxetine)	Milder, later-starting symptoms	Return of depression

How to Support a Loved One Through Withdrawal

Family members can make drug withdrawal safer and less frightening for the person going through it.

1. Bring in medical help first. A doctor or a medically supervised detox team can judge which risks apply to the drug involved and how withdrawal should be managed.
2. Create a calm place to rest. The WHO recommends a quiet setting where the person can sleep, rest or take short walks. Keep alcohol and drugs out of the home. Medicines for symptoms should come only on the advice of a doctor or pharmacist.
3. Learn the danger signs ahead of time. Knowing which symptoms call for 911 with this specific substance saves time in an emergency. Accurate, realistic information also eases the fear people feel during withdrawal, the WHO notes.
4. Stay patient through the slow weeks. Mood and sleep can take weeks to settle. Serious talks about the past can wait, since the WHO advises against starting counselling during withdrawal, when a person may be vulnerable and confused.
5. Look after your own health. Withdrawal can stretch over days or weeks of broken sleep and worry for the people nearby too. Sharing the watch with another family member keeps one person from carrying it alone.

Ready to Take the First Step?

Addiction doesn't get better on its own. Call us today for a free, confidential consultation and find out which program is right for your needs.

Call 1-855-499-9446

FAQ