What Drugs Have the Longest Withdrawal Periods and Why?

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Almost any substance we consume in large amounts, legal or illegal, is going to cause withdrawals. It’s true of processed foods, caffeine, and sugar. Once our bodies grow dependent on something, there’s a period where it starts adjusting back to normal if we halt using. 

This is especially true for drugs, and since they change our brain chemistry, we go through a period where the body adjusts itself when drug use stops. The process is known as withdrawal, which is defined as a set of typical signs and symptoms resulting from an abrupt decrease or sudden removal of a standard dose of your drug of choice. The withdrawal symptoms will vary based on several factors, such as the type of drug used, length of use, and how many times a person has gone through it before. 

Someone that’s used depressant medications or illicit depressants will rebound with overstimulated symptoms during their withdrawal period. For someone abusing excitatory drugs like stimulants, they’ll experience rebound depression of physiologic function upon cessation when withdrawals start. 

Since different drugs affect different parts of the brain, you can expect cocaine withdrawal to be different than opioid withdrawal. A person’s age and how much of the drug they use are other factors that go into how long and intense withdrawal could be. 

Acute withdrawal is commonly viewed as an unpleasant experience and is one of the primary reasons most drug or alcohol users won’t stop using. Below we’ll take a look at the drugs with the longest withdrawal periods. 

Opioid Withdrawal Period

Prescription painkillers and heroin are considered opioids. Narcotic analgesics, also known as painkillers, are derived from the seed pod of the poppy plant. Opioids are considered among the most addictive substances on the planet, and even following your doctor’s orders can lead to addiction. Although opioid withdrawal isn’t considered life-threatening, it’s regarded as one of the worst withdrawals of any drug. The most common symptoms include:

  • Vomiting
  • Diarrhea
  • Nausea
  • Sweating
  • Abdominal cramps

Once the drug leaves your system and the acute withdrawal symptoms start to fade after a week, there’s another stage you’re likely to encounter – post-acute withdrawal syndrome (PAWS). PAWS is the phase of withdrawal that can last weeks, months, or in rare cases, up to a year. PAWS occurs when acute withdrawal symptoms persist despite all traces of the drug leaving your system. Long-term opioid use is notorious for users experiencing the condition. The symptoms include impairment of attention span, energy, concentration, memory, appetite, sleep, and mood. The most common symptom is increased anxiety, anger, and depression.

Oxycodone Withdrawal Period

The active ingredient in Percocet and OxyContin is the potent synthetic opioid known as oxycodone. Withdrawal may start as soon as eight hours after the last dose. The physical withdrawal symptoms will peak around 72 hours but can last up to a week. Symptoms will vary from one person to another, but the length of withdrawal depends on how long someone has abused the drug, how much they took, and their method of administration. 

Heroin Withdrawal Period

Heroin is considered one of the most potent substances on earth, and withdrawal can be especially hard. Heroin is a short-acting opioid that takes effect almost immediately, depending on how it’s administered. The effects of heroin peak in one to two hours and wear off anywhere from three to five hours. Heroin withdrawal can initiate within five hours after the last dose and continue for a week. The physical symptoms will taper anywhere from five to ten days, depending on how long someone has used the drug. The symptoms will vary from person to person. 

Benzodiazepine Withdrawal Period

Benzodiazepines belong in a class of drugs known as central nervous system (CNS) depressants designed to decrease brain activity. The drugs are considered tranquilizers or sedatives, and they’re extremely dangerous during the withdrawal phase. If you’re serious about stopping the use of benzos, you must attend a professional detox center to mitigate the dangers of detox. Withdrawals can be fatal, but also include:

  • Tremors
  • Insomnia
  • Anxiety
  • Psychosis
  • Seizures
  • Death
drugs-with-longest-withdrawals

Post-acute withdrawal syndrome is also attached to benzos and can last several months as your body starts producing its own GABA. PAWS can last up to a year, meaning a person trying to cope should consider therapy for help with their symptoms. 

Xanax Withdrawal Period

Xanax withdrawal symptoms can start a few hours after your last dose and peak in severity in one to four days. Since these symptoms can be severe, you must consider medical detox. The professionals will provide you with a tapering schedule to safely overcome your symptoms—symptoms last one to four days. Acute symptoms will start subsiding around two weeks after you stop. 

Stimulant Withdrawal Period

Stimulant drugs work to increase the levels of specific neurotransmitters within our brain. Stimulants “wake up” the receptors responsible for energy, alertness, and increased attention. Although stimulant withdrawal isn’t deadly, it can leave a user unable to sleep for several days and experience other uncomfortable symptoms. If you choose to attend detox, clinicians will prescribe depressant medications to help with the crippling depression. Other withdrawal symptoms might include:

  • Insomnia
  • Appetite loss
  • Cravings
  • Depression
  • Fatigue
  • Restlessness

Post-acute withdrawal syndrome stemming from stimulants can last years. Stimulants affect the reuptake of dopamine in the brain, which takes quite some time to rebound after prolonged amphetamine or cocaine abuse. A person experiencing PAWS will have additional challenges enjoying life because their dopamine levels are not the same as before they used drugs. 

Cocaine Withdrawal Period

There are three distinct phases during cocaine withdrawal – the first consists of a crash that occurs after stopping use, lasting a few days. Intense feelings of anxiety and depression will become present during this stage. The next phase is the withdrawal period, which can last up to ten weeks. It entails irritability, cravings, and periods of fatigue. The final portion, known as the extinction phase, is when an individual will continue experiencing cravings. It’s evident when they’re exposed to triggers, reminding them of cocaine use.

Methamphetamine Withdrawal Period

The half-life of methamphetamine is six to 34 hours, meaning withdrawal symptoms will emerge after one to five days and last up to eight. Withdrawal from methamphetamine is extremely uncomfortable, and someone going through withdrawal will experience impaired social functioning, depression, aches and pains, and persistent symptoms that remind them of using. Similar to cocaine, methamphetamine withdrawal symptoms can last several years if the drug was used for prolonged periods. You’ll need professional help to overcome these symptoms.

Sources

MedlinePlus (February 2021) Cocaine Withdrawal. from https://medlineplus.gov/ency/article/000947.htm

Department of Health Australia (April 2004) The Amphetamine Withdrawal Syndrome. from https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-3~drugtreat-pubs-modpsy-3-7~drugtreat-pubs-modpsy-3-7-aws

MedlinePlus (February 2021) Opiate and Opioid Withdrawal. from https://medlineplus.gov/ency/article/000949.htm

DEA (February 2021) Stimulants. from https://www.dea.gov/taxonomy/term/346

Psychology Today (May 2015) Detoxing After Detox: The Perils of Post-Acute Withdrawal. from https://www.psychologytoday.com/us/blog/some-assembly-required/201505/detoxing-after-detox-the-perils-post-acute-withdrawal

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