Coming Down From Drugs

A comedown from drugs refers to the withdrawal symptoms a person experiences when they quit using a substance. The onset of withdrawal symptoms may occur immediately after the substance was last used, or may take several hours or days to manifest. The symptoms of a comedown can occur whether a person has been using alcohol, prescription drugs, illicit drugs, or even over-the-counter drugs.

Sometimes physical and mental sensations are not immediately recognized by a user as withdrawal symptoms connected to the drug they have been taking — especially if they don’t realize they have become dependent on or addicted to a medication. For example, a person who has been using prescription opioid painkillers may begin experiencing a dramatic spike in pain accompanied by anxiety or agitation between doses or after a prescription runs out. They may think they require more painkillers to relieve these effects, rather than recognizing them as a sign that they should be weaned off the drug and transitioned to a non-addictive painkiller or alternative therapy.

Addictive drugs can cause physiological changes in the brain and body, altering the way a person’s central nervous system perceives pain or regulates emotions and mood. Certain drugs cause a dramatic surge in neurotransmitters such as dopamine and serotonin, which results in a powerful rush of pleasure or euphoria, called a “high.” Eventually, this artificially induced euphoria wears off, leaving the user feeling anxious and irritable or in great physical discomfort.

Coping with comedowns, whether from opiates or other drugs, can be quite difficult and even debilitating, which is why medically assisted detoxification is recommended for safe and manageable withdrawal from alcohol and many substances.

The withdrawal symptoms associated with a comedown from drugs can range from mild to acute. When a person has become addicted to alcohol or a drug, their body is so used to having a constant level of the substance in their system that it can take a while for them to detox, and to cope without it.

Opiates, for example, can stimulate a release of up to 10 times the amount of dopamine naturally produced in the brain and nervous system. The body compensates for this artificially induced surge of dopamine by reducing the natural production of this feel-good chemical. Therefore, when a person quits using opiates and undergoes detox, the absence of dopamine results in a constellation of symptoms and mood changes that can last until the body adjusts and starts naturally producing dopamine on its own again. The timeframe of this adjustment period can be several weeks, challenging a person’s coping mechanisms as they endure significant physical and emotional discomfort. This is why a world-class residential drug rehab program that provides medical, psychological and emotional support and teaches healthy coping strategies is recommended.

Detoxing from other drugs can be equally challenging. The duration and severity of a comedown is determined by a number of factors, including substance type, dosage, degree of physical tolerance to the substance, and a person’s physical and mental health. Not all people with addiction will experience comedowns the same way. Some people experience a gradual lessening of a drug’s effects, while others experience a sudden and intense crash.

When trying to quit a substance on their own, addicts may find the withdrawal symptoms so unbearable that they take more of the drugs to relieve the distress that accompanies the comedown, only accelerating the spiral of addiction. This is why detoxing in an addiction treatment setting is easier and safer. The care team can help ease the symptoms and provide comfort as substances are cleared from the body.

Opiates and opioids, a drug category which includes both the illicit drug heroin and prescription drugs like oxycodone (OxyContin) and hydrocodone (Vicodin), trigger a two-part withdrawal period. The early withdrawal symptoms are said to mimic the flu, and occur within the first 24 hours, including:

• Muscle aches
• Watery eyes
• Runny nose
• Fatigue
• Insomnia
• Agitation
• Anxiety
• Sweating

The second stage of opioid or opiate withdrawal symptoms may include:

• Nausea and vomiting
• Chills and goosebumps
• Diarrhea
• Abdominal cramps
• Dilated pupils

More severe withdrawal symptoms may require hospitalization and assistive medications may be needed to support and manage the detoxification process.

Since stimulants, which include methamphetamines and ADHD medications like Ritalin, increase vitality and euphoria, a comedown is likely to impact energy and mood. Withdrawal symptoms may include:

• Jitteriness
• Anxiety
• Paranoia
• Fatigue
• Insomnia or hypersomnia
• Hallucinations
• Dehydration
• Slowed speech
• Body aches

The duration and intensity of withdrawal symptoms are likely to vary depending on how long a person has been using stimulants.

Since depressants like sedatives and tranquilizers (i.e., benzodiazepines) depress or slow down body functions and inhibit or dull the response of certain chemical receptors in the brain to calm and relax a person, the cessation of these drugs can result in the opposite effect — heightened agitation. Withdrawal symptoms may include:

• Irritability and emotional outbursts
• Anxiety and panic attacks
• Sleep disturbance
• Inability to concentrate
• Memory problems
• Body aches, pains, and muscle stiffness

Hospitalization is strongly recommended for people withdrawing from depressants, particularly benzos, since severe cases can cause seizures and thoughts of suicide.

Alcohol is the most commonly abused substance and it is estimated that more than 15 million American adults have an alcohol use disorder or alcoholism. While trying to cut back on alcohol consumption is a good idea, quitting suddenly and without medical assistance can be difficult and even dangerous, due to the possibility of developing delirium tremens (also known as “the DTs) during withdrawal.

Alcohol withdrawal symptoms can include:

• Anxiety
• Tremors and shaking
• Nausea and vomiting
• Excessive sweating
• Insomnia
• Headaches
• Stomach cramps
• Diarrhea
• High blood pressure
• Elevated heart rate

Signs of delirium tremens can include confusion, severe vomiting, agitation, hallucinations, fever, and convulsions or seizures. If these symptoms occur when coming down from alcohol, it should be treated as a medical emergency. Alcohol detox is best done under medical supervision.

A number of prescription cold and allergy medicines and over-the-counter medications can be addictive and have become popular drugs of abuse. These include codeine cough syrups, promethazine antihistamines, and OTC decongestants. The prescription cold and allergy medications tend to have a sedating effect, while many OTC decongestants have a stimulating effect. Withdrawal symptoms from these drugs will vary, depending on whether they have sedative or stimulant properties.

Clearly, coming down from drugs is an unpleasant experience. However, the detox experience is far more manageable if it occurs in a professional addiction treatment setting where detoxification is supervised by a medical care team and the severity of withdrawal symptoms can be greatly reduced.

Detoxification is an important first step towards recovery. The medical care team can provide emotional support and make this difficult process as safe and comfortable as possible – don’t go through it alone. Once your symptoms have diminished and you are stabilized, the team can help you transition into a rehab program where you will receive counseling, addiction education and ongoing support for your continued healing and recovery.

If you or a loved one needs help with detox, contact us today. We can answer your questions about how alcohol or drugs affect you and what to expect during the detoxification process.

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