Writing Notes: Withdrawal Symptoms

heya!! Was wondering if you had any tips for writing characters going through withdrawal? Sorry if it's a weirder ask, but would a symptoms list be possible? Thanks in advance!!

Writing Notes: Withdrawal Symptoms

Withdrawal - Substance-specific physiologic effects, symptoms, and behavioral changes that are caused by stopping or reducing the intake of a substance.

It is a pharmacologic symptom in which untoward physical effects occur when the drug is stopped or when it is counteracted by a specific antagonist

Substance Withdrawal - A syndrome that develops after cessation of prolonged, heavy consumption of a substance.

Symptoms vary by substance but generally include:

physiological,

behavioral, and

cognitive manifestations, such as nausea and vomiting, insomnia, mood alterations, and anxiety.

DSM–IV–TR identifies 6 drug classes associated with withdrawal:

alcohol,

amphetamines,

cocaine,

nicotine,

opioids, and sedatives,

hypnotics, or anxiolytics.

DSM–5 and DSM-5-TR list

tobacco in place of nicotine and

further identify caffeine and

cannabis as being associated with a withdrawal syndrome.

To be classified as a substance-withdrawal disorder,

the withdrawal syndrome must cause the patient significant distress and/or impair functioning (e.g., social, occupational).

Most patients with withdrawal recognize that readministering the substance will reduce their symptoms.

ALCOHOL WITHDRAWAL

Alcohol Withdrawal - Symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking alcohol.

These symptoms tend to occur within 8 hours after the last drink, but can occur days later. Symptoms tend to peak by 24 to 72 hours, but may go on for weeks.

Common alcohol withdrawal symptoms include:

Anxiety or nervousness

Depression

Fatigue

Irritability

Jumpiness or shakiness

Mood swings

Nightmares

Not thinking clearly

Other alcohol withdrawal symptoms may include:

Sweating, clammy skin

Enlarged (dilated) pupils

Headache

Insomnia (sleeping difficulty)

Loss of appetite

Nausea and vomiting

Pallor

Rapid heart rate

Sweating, clammy skin

Tremor of the hands or other body parts

Delirium Tremens - a severe form of alcohol withdrawal. It can cause:

Agitation, irritability

Sudden, severe confusion (delirium)

Fever

Seeing or feeling things that aren't there (hallucinations)

Seizures

A continuum of symptoms and signs of central nervous system (including autonomic) hyperactivity may accompany cessation of alcohol intake.

A mild alcohol withdrawal syndrome includes tremor, weakness, headache, sweating, hyperreflexia, and gastrointestinal symptoms. Tachycardia may be present and blood pressure can be slightly elevated. Symptoms usually begin within about 6 hours of cessation. Some patients have generalized tonic-clonic seizures (called alcohol-related seizure, or rum fits) but usually not > 2 in short succession. Seizures generally occur 6 to 48 hours after cessation of alcohol.

Alcoholic hallucinosis (hallucinations without other impairment of consciousness) follows abrupt cessation from prolonged, excessive alcohol use, usually within 12 to 24 hours. Hallucinations are typically visual. Symptoms may also include auditory illusions and hallucinations that frequently are accusatory and threatening; patients are usually apprehensive and may be terrified by the hallucinations and by vivid, frightening dreams. Alcoholic hallucinosis may resemble schizophrenia, although thought is usually not disordered and the history is not typical of schizophrenia. Symptoms do not resemble the delirious state of an acute organic brain syndrome as much as does delirium tremens (DT) or other pathologic reactions associated with withdrawal. Consciousness remains clear, and the signs of autonomic lability that occur in DT are usually absent. When hallucinosis occurs, it usually precedes DT and is transient.

Delirium tremens usually begins 48 to 72 hours after alcohol withdrawal; anxiety attacks, increasing confusion, poor sleep (with frightening dreams or nocturnal illusions), profuse sweating, and severe depression also occur. Fleeting hallucinations that arouse restlessness, fear, and even terror are common. Typical of the initial delirious, confused, and disoriented state is a return to a habitual activity; eg, patients frequently imagine that they are back at work and attempt to do some related activity.

OPIOID WITHDRAWAL

Opiates or opioids are drugs used to treat pain.

Opiates are derived from plants and

opioids are synthetic drugs that have the same actions as opiates.

The term narcotic refers to either type of drug.

If you stop or cut back on any of these drugs after heavy use for a few weeks or more, you will have a number of symptoms. This is called withdrawal.

Early symptoms of opiate and opioid withdrawal include:

Agitation

Anxiety

Muscle aches

Increased tearing

Insomnia

Runny nose

Sweating

Yawning

Late symptoms of opiate and opioid withdrawal include:

Abdominal cramping

Diarrhea

Dilated pupils

Goosebumps

Nausea

Vomiting

These symptoms are very uncomfortable but are not life threatening. Symptoms usually start within 12 hours of last heroin usage and within 30 hours of last methadone exposure.

Withdrawal from opioids can cause:

Sweating

Chills

Anxiety

Agitation

Muscle aches

Insomnia

Abdominal cramping

Nausea

Vomiting

Withdrawal symptoms may increase in severity over 72 hours before beginning to ease. Unlike withdrawal from other drugs such as alcohol or benzodiazepines, withdrawal from opioids is uncomfortable but rarely life-threatening.

The opioid withdrawal syndrome usually includes symptoms and signs of central nervous system hyperactivity.

Onset and duration of the syndrome depend on the specific drug and its half-life.

Symptoms may appear as early as 4 hours after the last dose of heroin, peak within 48 to 72 hours, and subside after about a week.

Anxiety and a craving for the drug are followed by increased resting respiratory rate (> 16 breaths/minute), usually with diaphoresis, yawning, lacrimation, rhinorrhea, mydriasis, and stomach cramps. Later, piloerection (gooseflesh), tremors, muscle twitching, tachycardia, hypertension, fever and chills, anorexia, nausea, vomiting, and diarrhea may develop.

Opioid withdrawal does not cause fever, seizures, or altered mental status. Although it may be distressingly symptomatic, opioid withdrawal is not fatal.

The withdrawal syndrome in people who were taking methadone (which has a long half-life) develops more slowly and may be less acutely severe than heroin withdrawal, although users may describe it as worse.

Even after the withdrawal syndrome remits, lethargy, malaise, anxiety, and disturbed sleep may persist up to several months.

Drug craving may persist for years.

NICOTINE WITHDRAWAL

Common Nicotine Withdrawal Symptoms

Having urges or cravings to smoke

Feeling irritated, grouchy, or upset

Feeling jumpy and restless

Having a hard time concentrating

Having trouble sleeping

Feeling hungrier or gaining weight

Feeling anxious, sad, or depressed

Trying to quit smoking feels different for each person, but almost everyone will have some symptoms of nicotine withdrawal. When you stop, your body and brain have to get used to not having nicotine. This can be uncomfortable, but nicotine withdrawal can’t hurt you – unless you give in and have a cigarette. Over time, withdrawal symptoms will fade as long as you stay smoke-free.

CAFFEINE WITHDRAWAL

Caffeine intoxication and caffeine withdrawal are included in DSM-5-TR.

Caffeine use disorder, however, is in the section of DSM-5-TR for conditions requiring further research. While there is evidence to support this as a disorder, experts conclude it is not yet clear to what extent it is a clinically significant disorder.

Some signs of caffeine withdrawal include:

impaired behavioral and cognitive performance,

decreased or increased blood pressure,

decreased motor activity,

increased heart rate,

hand tremor,

increased diuresis,

skin flushing,

flu-like symptoms,

nausea/vomiting,

constipation,

muscle stiffness,

joint pains, and

abdominal pain.

Sources: 1 2 3 4 5 6 7 8 9 10 ⚜ More: Notes ⚜ Writing Resources PDFs

Hi, it's alright. This is an interesting topic and quite important to portray in literature and other media. The symptoms depend on which substance/s your character has been using, but each person may also have different withdrawal symptoms. You can find more details in the sources. Hope this helps with your writing!