drug withdrawal

definition

Drug withdrawal is a therapy that is intended to help addicts to stop using them and to remain permanently abstinent. The basis is weaning from the addictive substance. At the beginning there is physical detoxification. This can be done with or without medication (warm or cold withdrawal). Depending on the severity of the addiction, this part of the treatment can be carried out in hospitals or special rehab clinics and accompanied appropriately.

If necessary, a long-term therapy for permanent abstinence follows. It is usually a lengthy process that can take years. The exact process depends on the person, drug, and severity of the addiction.

Who Needs Drug Withdrawal?

In principle, weaning off a harmful addiction is always advisable. As part of an addiction, depending on the substance and amount, physical (e.g. organ damage) and psychological (e.g. depression) secondary damage can occur. Addictive behavior can become such a time-consuming everyday component that professional practice and social participation suffer as a result. Financial problems and isolation can result. All of those points are warning signs of the need for drug withdrawal.

Read more on the subject at: Consequences of drugs

An indispensable prerequisite is the individual will to free himself from his addiction. The urgency depends on the physical condition and the harmful influence of the drug.
Medically and psychotherapeutically supported withdrawal is particularly useful in the case of severe dependencies, hard drugs, poor physical or mental condition, as well as impending severe withdrawal symptoms. It is always an extremely stressful situation for the body.

Can you test in advance who will be able to withdraw from drugs?

It cannot be said with certainty whether someone will manage to withdraw. The most important prerequisite for a successful therapy is the independent motivation to free oneself from one's dependency. Whether this will is sufficient can be clarified in advance in a conversation. It is important to promote the self-motivation of the person concerned before and during the withdrawal.

The respective living conditions are also of great importance. A consuming environment should be avoided. Support from family members and friends as well as professional integration provide support and increase the chances of success. After physical detoxification, long-term abstinence is a major challenge. Medical and psychotherapeutic support can help those affected to lead a long-term drug-free life.

How do I find a good drug rehab clinic?

Doctors and especially drug advice centers can help find a suitable clinic. The latter can be found in almost all cities. They advise, refer to institutions and help with preparation for withdrawal. You are always there to support you, even during or after therapy. The goal is a drug-free life and reintegration into society. Contact information for advice centers can be obtained from doctors or city administrations and researched on the Internet.

You can also search for suitable rehab facilities directly online. There are numerous clinic directories, for example from the Fachverband Sucht e.V., onherapieplatz.de., At "jameda" or on Drogen.net. There are also many private clinics with their own websites. It is advisable to search directly for the desired region and, if necessary, for specializations (alcohol withdrawal, opioid withdrawal, etc.).

Read more on the topic: alcohol withdrawal

Can I also go through drug withdrawal at home?

This depends on the drug, the duration and amount of use. Nicotine, cannabinoids (marijuana) and hallucinogens (LSD, mescaline) cause relatively mild withdrawal symptoms and can theoretically be weaned in the home environment. Medically and / or psychotherapeutically accompanied withdrawal is, however, safer and more promising. This can be inpatient (in a medical facility) or outpatient (accompaniment within the framework of regular appointments).

It is advisable to visit your family doctor before attempting withdrawal and to decide together on the individual approach. If you have already started withdrawal independently, you should always consult a doctor if you experience restlessness, anxiety attacks or other psychological or physical problems. In the case of harder drugs (e.g. heroin, cocaine, amphetamines, alcohol, sedatives) and severe addiction, a hospital or a special detoxification clinic should be visited in any case.

The withdrawal symptoms can be life-threatening, depending on the substance. Circulatory problems, seizures, and self-harming or self-damaging confusion are possible. It is strongly recommended that you be accompanied by a doctor. Withdrawal can be professionally monitored and, if there are problems, you can quickly intervene. In addition, medication can significantly reduce discomfort during detoxification.Overall, it should be emphasized that the chances of success are significantly higher with professional support.

What is the drug withdrawal process like?

The withdrawal consists of a physical detox and a subsequent weaning therapy. Detoxification usually takes place on an outpatient basis (at home, accompanied by fixed doctor's appointments) or inpatient (hospital, withdrawal clinic). During this time, the person concerned receives close support from doctors and psychotherapists as well as any necessary medication support. The focus is on physical weaning from addiction. Discussions with specialist staff are available to provide support.

This is followed by weaning therapy. This is usually done on an outpatient basis. The person affected is connected to accompanying programs via doctors, therapists or drug counseling centers, if this is desired. Psychotherapies are possible in individual or group meetings, such as Alcoholics Anonymous. These should help to build and maintain a regular life without drugs.

What are the typical symptoms of drug withdrawal?

These vary depending on the substance and previous consumption behavior. In a way, the withdrawal symptoms show up as the opposite of the effects of the drug in question.

• With opioids, palpitations, diarrhea, vomiting, restlessness, sweating, pain, blood pressure crises and dizziness occur. These symptoms peak approximately 36-72 hours after the last dose and can last up to 8 days.
• In comparison, cannabinoids and hallucinogens cause only minor physical withdrawal symptoms. Fluctuating moods through to depressive moods and "flashbacks" are possible.
• Cocaine also shows only minor physical, but enormous psychological withdrawal symptoms. Those affected suffer from massive fluctuations in mood, anxiety and the extreme urge to take the drug again.
• Withdrawal symptoms from alcohol and benzodiazepines (sedatives) are similar and often severe: clouding of consciousness, disorientation, hallucinations (seeing "white mice"), palpitations, tremors, sweating, vomiting, blood pressure crises and seizures are possible.

Read more on the topic: Drug addiction

Therapy during drug withdrawal

Withdrawal is a combination of medical and psychological treatment. In any case, a doctor accompanies and monitors the detoxification process. Physical withdrawal symptoms may be counteracted with medication. Psychotherapeutic support is just as important.

Those affected often suffer from psychological problems. Whether caused by the addiction or underlying it cannot always be separated. Discussions can be used to deal with your own addiction career, problems relating to home, training or work, as well as relationships with relatives and friends. Additional offers such as occupational therapy, art therapy and music therapy are often available during a stay in the clinic. Even during the detoxification process, efforts are made to reorganize everyday life without addiction.

Likewise in the subsequent connection to outpatient psychotherapy or group meetings (e.g. anonymous alcoholics). Here there is also the opportunity to meet other addicts and exchange ideas. In this way, the feeling of social isolation and shame that those affected often suffer from can be counteracted.

What drugs are used in drug withdrawal?

The withdrawal symptoms that occur during physical detox can be treated or at least alleviated with medication. This is of particular importance with alcohol and benzodiazepine withdrawal, which can be associated with life-threatening complications. Depending on your physical condition, it may be necessary to monitor your circulation closely and to administer fluids via the vein.

In general, neuroleptics / antipsychotics and antiepileptics / anticonvulsants are used. The former have a dampening, calming and antipsychotic effect (i.e. counteracting the loss of reality of a psychosis). They help with anxiety and restlessness as well as delusions. To prevent seizures, antiepileptic / anticonvulsant drugs (i.e., anticonvulsant drugs) are usually administered. These originally come from the treatment of epilepsy.

Withdrawal from alcohol can lead to severe physical withdrawal symptoms such as circulatory instability, seizures and nerve disorders caused by vitamin deficiency. These must be considered and, if necessary, dealt with quickly. In addition to the drugs mentioned above, antihypertensive agents, sedatives such as clomethiazole, benzodiazepines and vitamins (B1, B6, B12, folic acid) are also used.

Benzodiazepine withdrawal is also often associated with severe withdrawal symptoms. These are similar to alcohol withdrawal. To alleviate the severity of the disease, it is common to slowly reduce the dosage ("tapering off"). This means that the affected person is weaned with steadily decreasing doses. As with alcohol withdrawal, antispasmodic agents and antipsychotics are used as a preventative measure.

Are there any special features of alcohol withdrawal?

Alcohol withdrawal is fraught with particular difficulties. Frequently, abrupt detoxification leads to the so-called alcohol withdrawal delirium. This means the occurrence of various severe withdrawal symptoms.

Clouds of consciousness, hallucinations and circulatory problems are typical. Medical accompaniment is urgently required. If necessary, the circulation should be closely monitored and the patient should be given an infusion of fluids. In addition, there is the risk of seizures, which one tries to counteract with the precautionary administration of epilepsy medication. As described above, antihypertensive agents and sedatives can also be used.

In long-term weaning, there are drugs such as "Acamprosat", "Disulfiram" and "Naltrexone", which are supposed to prevent the desire for alcohol and thus relapses.

How long is drug withdrawal duration?

The withdrawal consists of the (more physical) detoxification and the (more psychological) weaning. The former usually lasts between two and six weeks. The length of the subsequent weaning cannot be precisely predicted. Those affected often suffer from psychological problems that are the basis of drug abuse or that arose from it.

In order to achieve the goal of long-term abstinence, a holistic view is required. There is usually long-term psychotherapeutic support in the form of one-on-one discussions or group therapies. In addition, there are influencing factors such as the patient's self-motivation, the drug, previous consumer behavior, regular everyday structures, the connection to family, friends and professional life. Overall, long-term weaning can take a few months to years.

How high is the relapse rate?

There are no exact numbers, but relapses are unfortunately common. It is not uncommon for several withdrawal attempts to be necessary. Of course, it depends on the drug, the severity of the addictive behavior and the social environment. Physical withdrawal is only the first step. Long-term abstinence often remains a challenge for years to life.

In addition, drug use has usually left clear traces in the lives of those affected in advance: unemployment, withdrawal from relatives and friends as well as psychological problems due to the sudden loss of the previously always available feeling of intoxication. A lack of perspective and isolation creates a difficult environment that offers little support for drug abstinence. It happens that formerly dependent persons return to their old consumer behavior. Therefore, professional psychotherapeutic and, if necessary, social service support is important. These help those affected to create suitable living conditions and thus reduce the risk of relapse.

What can I do about relapse after drug withdrawal?

It is important to create the right framework for a permanently drug-free life. A drug-free social environment, a regular daily routine, a professional activity, sport or other leisure time compensation are important. Long-term psychotherapy can be accompanying and supportive. In conversations, topics such as addictive pressure, fear of relapse or other emotional problems can be discussed and those affected can be relieved.

Drug advice centers also provide information on offers such as group therapies or discussion groups. Creating awareness that you are not alone can motivate and also prevent relapse. Drug withdrawal is a long-term affair and support from family members or others is helpful.