Acute withdrawal and protracted withdrawal are common phases of the addiction cycle. Learn what each form of withdrawal is, what to expect, and how to overcome difficult symptoms.

One of the most common signs of a substance use disorder (SUD) is the presence of withdrawal syndrome. Withdrawal syndrome occurs when a user stops taking drugs or alcohol after a period of prolonged substance abuse. With repeated use, these substances have toxic effects on the brain and the body, altering a person’s chemical make-up and making them dependent on the drugs to function. So, when drugs are removed from their routine, the body begins to experience great pain and discomfort – demanding more of the drug to function again.

Symptoms of withdrawal vary, but can include flu-like symptoms, insomnia, anxiety, depression, seizures, and lethargy. These symptoms are physically tolling, sometimes life-threatening, and lead many people back into using drugs again. Withdrawal symptoms typically occur in users who try to stop taking drugs on their own, or who go through a period in which they are unable to acquire a drug. All addictive substances, both prescription and illicit, can trigger withdrawal syndrome.

Most people who are addicted to drugs or alcohol will experience withdrawal in some form. Depending on the timeline of a person’s symptoms, one can experience different types of withdrawal: acute withdrawal and protracted withdrawal. The distinction between these two withdrawal syndromes is based on how long a person’s withdrawal symptoms last.

What is Acute Withdrawal?

Acute withdrawal happens almost immediately after an addicted person stops using drugs or alcohol. It is the initial withdrawal period that triggers difficult, physical symptoms like nausea, vomiting, tremors, muscle aches, and fatigue. Acute withdrawal can also involve psychological symptoms like irritability, anxiety, and mood changes. 

Typically, acute withdrawal syndrome will last several days and up to two weeks. It is often considered the first stage of the detoxification process, as acute withdrawal happens directly following the cessation of drug use. 

Acute withdrawal symptoms can range in severity, depending on the drug. Some drugs, like benzodiazepines, can cause life-threatening withdrawal symptoms. While not all drugs have dangerous effects associated with withdrawal, most cause difficult withdrawal symptoms that will disrupt one’s day-to-day life. Acute withdrawal often causes people to feel sick, lethargic, and unable to get out of bed. As a result, this is a period in which relapse is very likely. Introducing drugs into the system during a withdrawal period can alleviate difficult symptoms, unfortunately contributing to the greater cycle of addiction.

For this reason, it is recommended that those struggling with addiction seek medically supervised detoxification. Detoxification is the first step to recovery, allowing the body to rid itself of drugs and overcome withdrawal symptoms in a managed, clinical setting where help is available. Quitting drugs on your own, cold turkey, poses great dangers related to withdrawal. A medical setting meant for the withdrawal period, where you can start your recovery in good care, without judgement, is always recommended. This can also reduce the time spent recovering from withdrawal symptoms.

After a few days or weeks in detox, it is typical for one to enter a long-term treatment facility to overcome their deep-seated behaviors and potential mental health struggles, as they relate to addiction. This is key for a successful, long-term recovery. 

In some cases, however, withdrawal symptoms do not dissipate after a couple of weeks. While most physical symptoms subside after the acute withdrawal period, the mental health symptoms that stemmed from withdrawal, such as depression, can carry on much longer. This indicates a person is battling prolonged or protracted withdrawal syndrome. 

What is Protracted Withdrawal?

As noted above, physical withdrawal symptoms typically do not last longer than two weeks, especially when a clinical professional helps to manage the detox process. However, some cases can lead to a period of protracted withdrawal. Protracted withdrawal syndrome is a continuation of withdrawal symptoms, even after the body has healed from the physical side effects. 

Protracted withdrawal syndrome lasts between several months and a couple of years, depending on the severity of a person’s prior drug abuse. Individuals who battled substance abuse for a long period of time, and/or who consumed a large amount of a substance historically, are more likely to develop protracted withdrawal symptoms. 

Protracted withdrawal may also be referred to as prolonged withdrawal syndrome or, more commonly, post-acute withdrawal syndrome (PAWS). 

Protracted withdrawal happens as a result of the toxic changes and chemical imbalances that drugs and alcohol cause in a person’s brain. The longer a person has been using, the more the brain becomes reliant on these substances to function. It is not uncommon for people who have been struggling with addiction to experience prolonged symptoms of brain fog, insomnia, depression, anxiety, and intense drug cravings months after they stopped using drugs. Their body’s systems may have healed from the drug abuse, but the brain requires more time to recover and relearn how to function without drugs. This is where long-term drug treatment can help.

Long-term drug treatment helps users overcome the psychological effects and behavioral changes caused by substance addiction. Individuals can get to the root of their drug problem, develop coping mechanisms, learn how to handle drug cravings, create healthy routines, and acquire sober activities to bring into their life after rehab.

Without treatment, post-acute withdrawal syndrome can be completely disruptive to a person’s everyday life. Because the symptoms are largely related to mental health, PAWS or protracted withdrawal can cause a person to isolate from others, and have dangerous thoughts of suicide or using drugs again. Common symptoms of protracted withdrawal include:

• Depression
• Sudden changes in mood
• Extreme drug cravings and obsession of drug use
• Anxiety
• Panic attacks
• Suicidal thoughts
• Irritability and hostility
• Inexplicable chronic pain
• Confusion, memory problems, and general cognitive impairment
• Anhedonia, or the inability to feel pleasure from anything other than the drugs

It’s worth noting that post-acute withdrawal syndrome can be exacerbated by other mental health issues that a person is struggling with. For example, depression and alcohol abuse are very common, as with anxiety and drug abuse. These are examples of co-occurring disorders, which are often present before PAWS takes effect. Protracted withdrawal can make the symptoms of mental health disorders worsen, and vice versa. For those struggling with mental health, a dual diagnosis treatment setting is recommended. Here, one can receive treatment for their substance use disorder and mental health disorder simultaneously, in one integrated setting.

Acute vs. Protracted Withdrawal: A Recap

As discussed above, acute withdrawal and protracted withdrawal syndrome are both common for people struggling with substance addiction. Here is a summary of the key differentiators of each:

• Acute withdrawal lasts up to a couple weeks, whereas protracted withdrawal can last up to a couple years.
• Acute withdrawal is primarily associated with physical symptoms, such as nausea, congestion, fatigue, and seizures. Protracted withdrawal primarily involves psychological symptoms, such as depression and disturbed sleeping patterns.
• Acute withdrawal affects most people struggling with substance addiction. Protracted withdrawal is more common among those with longer-term or deep-seated substance use disorders, or who used large amounts of a drug.
• Acute withdrawal is best managed in a supervised, clinical detox setting. It should then be followed by longer-term addiction treatment. Protracted withdrawal syndrome, meanwhile, requires long-term treatment to resolve and recover from the more severe changes addiction had caused.

If your loved one is struggling with a substance addiction, a mental health disorder, difficult withdrawal symptoms, or a combination of the above, it is important to seek help. Withdrawal from drugs can be dangerous if not managed in a clinical setting, and often leads individuals back into abusing drugs. As a drug treatment center for young adults, Turnbridge can help guide you in the right direction. Contact 877-581-1793 to learn about our treatment programs and the options for you or your loved one.