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The Timeline of Withdrawal for
the Top 5 Most Addictive Substances

Withdrawal varies from substance to substance and even from person to person. An individual may face severe symptoms if they have been abusing alcohol for most of their life.

Or a person facing the beginnings of addiction with their opioid prescription may experience very mild withdrawal symptoms. That being said, there is no universal withdrawal timeline, so we’ve compiled a list of the top 5 most addictive substances to explore their individual withdrawal timelines and symptoms.

Alcohol

6 Hours

About 50% of people with an alcohol use disorder will experience symptoms during withdrawal. For some, these symptoms may start as early as 6 hours after the last consumption of alcohol. Symptoms include:

  • Feelings of anxiety
  • Trembling hands and/or legs
  • Headache
  • Nausea
  • Sleeplessness
  • Night sweats

12-24 Hours

Between 12 to 24 hours the above symptoms may persist in addition to hallucinations and seizures.

24-48 Hours

Between 24 to 48 hours, initial symptoms may lessen but some have reported persistent symptoms like headache, shaking, and upset stomach/digestive issues.

48-72 Hours

Between 2 to 3 days, some people facing more severe alcohol addiction may experience alcohol withdrawal delirium. This condition is known as Delirium Tremens (DT) and has the potential to cause the following symptoms:

  • Elevated heart rate
  • Seizures
  • Fever
  • Paranoia
  • Delusions

Over 72 Hours

Exceeding 3 days, more severe cases may see a spike in DT symptoms. At this point, withdrawal may be at its worst before leveling off to a more manageable state.

Extended Recovery Outlook

Alcohol is likely the most habit-forming and addictive substance on this list despite not being considered a “hard” drug. Alcoholism is difficult to overcome because alcohol is so widely available and accessible. Nearly any grocery store, restaurant, or social event carries the risk of temptation and relapse.

Opioids

6-30 Hours

Between 6 and 30 hours, opioid withdrawal can set in fast with symptoms as follows:

  • Muscular aches 
  • Runny nose
  • Insomnia
  • Decreased oxygen saturation
  • Anxiety
  • Elevated heart rate
  • Sweating
  • Fever
  • Increased blood pressure

3-7 Days

Between 3 and 7 days, withdrawal symptoms may increase in severity and more advanced symptoms may arise:

  • Diarrhea
  • Nausea
  • Vomiting
  • Cravings
  • Stomach pain
  • Depression

1-2 Weeks

Between 1 and 2 weeks, some people may experience Post-Acute Withdrawal Syndrome (PAWS) with extended symptoms including long-term psychological effects like depression and anxiety. Health complications may arise from some of the symptoms listed which makes medical intervention and detox crucial for opioid withdrawal.

Extended Recovery Outlook

Opioids have one of the most difficult withdrawal periods of any of the substances on this list. But even though symptoms are severe, they are often very short-lived in most average cases. Once initial withdrawals subside, sobriety is substantially easier to manage.

Cocaine

First 48 Hours

In the first 48 hours, many people quickly experience a cocaine “crash” which is the sudden and intense onset of withdrawal symptoms. These symptoms tend to fall more on the psychological side of the spectrum rather than the physical and can include:

  • Fatigue
  • Sleepiness
  • Tiredness
  • Anxiety
  • Irritability
  • Agitation
  • Paranoia
  • Apathy

1-10 Weeks

Between 1-10 weeks the above symptoms may persist in addition to:

  • Cravings
  • Depression
  • Appetite changes
  • Feelings of uneasiness
  • Insomnia
  • Fatigue

6 Months

At this stage, cravings begin to lessen but may arise when faced with addiction triggers specific to the individual. Some people recovering from cocaine addiction may experience what’s known as “cocaine headaches” which are similar to migraines.

Extended Recovery Outlook

Despite having one of the longest timelines on this list, recovery from cocaine addiction poses virtually no complications outside of lingering cravings. 

Heroin

6-12 Hours

Between 6 to 12 hours, heroin withdrawal sets in fast with symptoms as follows:

  • Sleeplessness
  • Nervousness
  • Diarrhea
  • Dilated pupils
  • Feeling anxious
  • Muscular aches
  • Shaking
  • Panic attacks

1-5 Days

Between 1 and 5 days, symptoms will worsen with many people reporting a peak in symptoms on the third day. Additional symptoms during this time include:

  • Stomach cramps
  • Sweating
  • Chills
  • Nausea and vomiting

1 Week

After one week, symptoms will level off but in more extreme cases, individuals may experience lasting effects of Protracted Withdrawal Symptoms (PAWS). Symptoms can include:

  • Anxiety
  • Depression
  • Panic attacks
  • Disoriented thinking
  • Loss of coordination

Extended Recovery Outlook

Like opioids, heroin withdrawal can be physically taxing and dangerous—even fatal without medical intervention.

Barbiturates

24-72 Hours

Between 24 to 72 hours, individuals may experience symptoms as follows:

  • Changes in heart rate
  • Nausea
  • Vomiting

4-7 Days

Between 4 to 7 days, additional symptoms may arise:

  • Insomnia
  • Irritability
  • Mood changes
  • Psychosis (in severe cases)

If symptoms persist beyond 3 weeks, the affected individual may be experiencing PAWS which can last up to a year after the initial withdrawal.

Extended Recovery Outlook

Despite the effects of PAWS in severe cases, barbiturate withdrawal can be managed in detox, and the recovery outlook is generally positive.

Detox With Briarwood

Briarwood Detox Center offers detox treatment for alcohol, opioid, methamphetamine, prescription drugs, and much more. Our experienced clinical staff provides round-the-clock monitoring throughout the detox process and our therapy team provides support to help manage the emotional response to treatment. Additionally, we have detox facilities located in Austin, Houston, and Colorado Springs with state-of-the-art amenities.

Briarwood is dedicated to facilitating a healthy and safe environment that empowers people to make significant and lasting changes in their lives. We look forward to supporting you or your loved one on the journey to recovery. Call (512) 277 – 3103 today for more information on our programs and admission process.

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