Withdrawal Sickness: How an Addict Gets Addicted to Addiction
Withdrawal Sickness, or the fear of it, is what keeps the addict addicted.
For the addict who has suffered the impact of a full scale withdrawal – or, whole body horror as one addict put it – they know it’s something they don’t ever want to go through again.
Depending on circumstances, withdrawal symptoms can go from uncomfortable to agonizing to life-threatening. How agonizing or life-threatening the experience depends on the extent of your addiction, how much you’ve been using and for how long, and your drug of choice.
But there can be a lot more going on with withdrawal than just discomfort and fear. Substance abuse changes the brain. With abuse, the reward center of the brain is damaged. The release of dopamine, the reward neurotransmitter, is blocked. Normal dopamine producing experiences, like good food, a walk in nature, a monetary reward, even sex, can become much less rewarding. The degree to which a substance effects the reward is directly linked to the speed in which it promotes dopamine release. This is why heroin is so much more addictive than, say, marijuana.
How the Brain Is Undone
Substances create an extreme shortcut to the brain’s pleasure center in a way that a natural experience couldn’t possibly duplicate. As a result, the brain is not equipped with an easy way to withstand this unnatural flood of pleasure chemicals. So, the brain shuts down its natural dopamine production in the reward system and for the addict, the substance becomes the only way to fulfill that dopamine feel. A system that had evolved in the brain over thousands of years, breaks down. The addict may require constantly increasing doses of the substance. Eventually, this system will no longer function and even the substance will no longer provide the pleasure. The substance will be necessary just to keep the addict from feeling the sickness of withdrawal.
The Condition of Conditioning
It’s not just the brain’s reward system that is changed: Behavior is also changed through classical conditioning. Substance abuse becomes a compulsion. As addicts are repeatedly exposed to drug-associated cues, they develop associative responses to these cues or triggers. These triggers can be practically anything – a person, place, or thing. Some are concrete, like a bar or club or a person you knew when you were using, or even a smell; some are more abstract like feelings of boredom or stress. It’s these triggered cravings that can remain long after the physical dependence is gone. They are also important factor in relapse.
The brain does heal, eventually, but not quickly.
Below, what to expect when withdrawing from the most difficult and addictive of drugs.
For opiate withdrawal, doctors describe the symptoms as being akin to a really bad case of the flu. Addicts themselves have described it as an unmitigated hell. Uncomfortable and painful – yes – but it is rarely dangerous.
However bad the acute or physical portion – you may experience sweats, nausea, diarrhea, chills, and dehydration among other things – and however long – it can go on for weeks, depending – the mental withdrawal may be even worse. This mental stage is referred to as the Post-acute Withdrawal Stage (PAWS). Here, the physical symptoms dissipate and brain chemistry returns to a normal state, a state the brain may not have experienced in a long time. Feelings and traumas may rise up that you had been using to avoid. With this stage can come severe depression and a hopeless feeling that you’re never going to get out of it. A cornucopia of other psychological and emotional symptoms may follow: Anxiety, irritability, insomnia, headaches, poor concentration, and thoughts of suicide. This feeling of malaise can go on for months (or longer, again, depending).
Benzos were the next step in the evolution of drugs after barbiturates. The problem with barbiturates was that correct dosages were hard to predict and overdosing was too easy. Even a slight error could lead to an overdose causing coma or death. They were also addictive.
Benzos are fast acting and habit-forming. While some anxiety or antidepressant medications take some time to be effective, benzos act immediately. Withdrawal from extended use can be difficult and dangerous. So much so, in fact, that the drug gets its own syndrome: The Benzodiazepine Withdrawal Syndrome. Ironic that a medication used for anxiety would have as a consequence of its withdrawal elevated tension and anxiety, but it does. The symptoms can include panic attacks, hand tremors, insomnia, difficulty concentrating as well as dry retching, nausea, palpitations, headache, and muscular pain and stiffness. Those used to taking high doses can encounter psychotic reactions and seizures. It is best to stop the drug only under the supervision of a doctor or medical detox.
In stopping the use of the drug it is best to do so with a slow and gradual tapering. As with opiates, the amount of the drug taken and for how long will have a great effect over the user’s withdrawal experience. Expect the withdrawal symptoms to last from a few weeks to several months.
Dependence on sedatives or alcohol can increase the risk of benzo dependence.
For a heavy drinker, withdrawal can also be severe. A person can experience visual, auditory, and tactile hallucinations. In extreme cases withdrawal can also trigger seizures, especially if the person has previously undergone multiple detoxifications.
As with opiates, alcohol also effects the brain’s neurotransmitters. Alcohol initially enhances the effect of GABA, a brain chemical that produces feelings of relaxation and calm. Chronic alcohol consumption suppresses GABA activity and increases tolerance so that more alcohol needs to be consumed to produce the desired effects. Alcohol also effects glutamate, a chemical that produces excitability. To compensate and maintain equilibrium, the glutamate system in chronic abusers reacts by suppressing glutamate. When the abuser suddenly stops, the opposite happens – neurotransmitters previously suppressed now overcompensate and the result is a condition known as brain hyperexcitablilty. The brain, once subdued by the depressant, will respond in withdrawal with anxiety, irritability, agitation, tremors, seizures and delirium tremens.
Prolonged alcohol abuse can lead to a number of body ailments – pancreatitis, nervous system impairment, liver disease, heart and artery disease, gastrointestinal bleeding, among others. It is important that a doctor be consulted when attempting withdrawal after chronic heavy use – withdrawal can be dangerous. A medically supervised detox is advisable.
Lasting Changes in the Brain
Because of the considerable chemical changes made to the brain by the substances of abuse, when an abuser attempts to withdraw the result will be a kind of shock – emotionally, behaviorally, and cognitively. Damage is done to brain pathways that are involved in reward, pain relief, stress maintenance, sleep and arousal, learning, and memory. This effects can last long time past the quitting and they can be deep: The brain can create unconscious memories. These deeply embedded hidden memories can affect the triggering of relapses.
A medically-supported detox program can not only provide a safe place to withdraw, it can also mitigate the immediate pains and discomforts. But the road of recovery is a long one. Addiction is a deep wound, and like the healing of any deep wound recovery takes time. But, with proper support, the recovering addict find lasting comfort.
Remember this: No one ever regrets going sober.
If you or a loved one have an addiction to alcohol, contact BLVD Treatment Centers. At BLVD Treatment Centers we custom tailor our recovery programs within the safe and nurturing confines of our rehab treatment centers. Located throughout California, in Los Angeles, Orange County, San Diego and in Portland, OR, our mission is to assess the severity of your addiction to help you achieve true recovery within 30 days. Call us now at 1-866.582.9844.