Withdrawal Timelines for Club Drugs

Club drugs tend to be used by young adults and teenagers at nightclubs, bars, parties, and concerts.
 
According to the National Institute of Health, club drugs include GHB, LSD, ketamine, MDMA, methamphetamine, and Rohypnol. Withdrawal timelines from these drugs vary according to the specific drug, particulars of the individual, and other factors.

GHB 

GHB (gamma-Hydroxybutyric acid) is a metabolite that acts as a central nervous system depressant and is chemically similar to the inhibitory neurotransmitter gamma-Aminobutyric acid. Thus, GHB is a central nervous system depressant. It has some clinical uses as a potential anesthetic, in the treatment of insomnia and narcolepsy, in the treatment of alcoholism, and may have utility as a potential adjunctive treatment for clinical depression. The drug is also used as a recreational drug due to its abilities to produce euphoria and its reputation as an aphrodisiac. It has been used as a date rape drug, and it goes by a number of different street names, including liquid ecstasy, lollipops, and Georgia home boy.

Despite a number of online reports stating that GHB is safe to use, there is a documented withdrawal syndrome associated with discontinuing GHB. The withdrawal process is similar to a combination of alcohol withdrawal and benzodiazepine withdrawal that appears to occur in three discrete stages:

Early acute withdrawal symptoms occur 1-24 hours after discontinuation of heavy use. These can include:

  • Marked insomnia and severe intermittent tachycardia
  • Moderate nausea, vomiting, insomnia, anxiety, delirium, and/or confusion
  • Mild symptoms of tremors, hypertension, and sweating

Over the next 1-6 days, there is progressive change in symptoms that indicates a peak in most of the withdrawal symptoms, including:

  • Severe anxiety, restlessness, confusion, delirium, hypertension, insomnia, and the potential for hallucinations
  • Moderate levels of sweating, tremors, and hypertension
  • Mild issues with nausea and vomiting
  • Finally, a period of extended episodic symptoms that begin after about one week following discontinuation and last for an additional week. Symptoms include:
  • Intermittent episodes of severe delirium
  • Intermittent episodes of moderate anxiety, insomnia, confusion, tachycardia, and hallucinations
  • Mild tremors, sweating, nausea, and vomiting

The potential for seizures is also documented at any stage in the withdrawal process. Seizures can be potentially fatal, and individuals experiencing these should get immediate  medical attention.

LSD (lysergic acid diethylamide) is a hallucinogen similar to drugs like psilocybin, mescaline, and PCP. LSD use produces very vivid visual hallucinations, alterations of mood, and may produce a sense of wellbeing or euphoria. In some users, it may also produce anxiety and hopelessness.

People who use LSD regularly may develop tolerance; however, there are no recorded cases of LSD withdrawal. There are few, if any, recorded instances of individuals exhibiting behaviors consistent with addiction to drugs like alcohol and cocaine. Some people who use LSD for longer periods of time may experience symptoms of malaise or dissociation upon discontinuation, but there is no withdrawal profile for this drug that is recognized.

Ketamine, also known as special K, is a dissociative anesthetic that has its primary mechanism of action in blocking the excitatory neurotransmitter N-methyl-D-aspartate (NDMA). It was developed in the 1960s to replace the drug phencyclidine (PCP). The full effects of this drug are not well understood.

There are some psychological effects  associated with discontinuing ketamine, such as lengthy periods of malaise, depressed mood, and loss of motivation. However, there is no formal withdrawal timeline recognized, and it is not believed that this drug produces significant physical dependence.

MDMA (3,4-methylenedioxy-methamphetamine), better known to some individuals as ecstasy,  is a synthetic drug that alters perception and mood. It is classified as a hallucinogen, although it has the combined properties of stimulant drugs and hallucinogens.

The National Institute of Drug Abuse reports that there are some studies that suggest that withdrawal symptoms from MDMA include fatigue, loss of appetite, depression, and difficulty concentrating. There is no formal timeline established for the withdrawal symptoms associated with discontinuation of MDMA. Many nonprofessional websites propose a withdrawal timeline for MDMA; however, these are not empirically validated.

Methamphetamine

Methamphetamine, more commonly known as crystal meth, is a powerful man-made stimulant drug that is a popular drug of abuse. It can be readily made by private individuals, and it is commonly snorted or smoked. Research indicates that the timeline for withdrawal from crystal meth following discontinuation follows this course:

  • Withdrawal begins rapidly following discontinuation of use, as crystal meth has a short half-life. Symptoms can appear within the first 24 hours after someone stops using the drug.
  • The symptoms peak within 4-10 days after stopping use and then decline in intensity.
  • The average duration for the withdrawal period is a total of 2-3 weeks with 2 weeks being the most often reported average duration of withdrawal.
  • Primary withdraw symptoms include symptoms that are typically associated with discontinuing powerful stimulants, such as:
  • Extreme cravings for the drug that peak within the first week
  • Marked fatigue, lethargy, and excessive sleepiness which peak within 4-6 days
  • Increase in appetite, nervousness, and other related symptoms
  • Depressive symptoms that peak within the first week and decline thereafter, but may extend for months after discontinuation
  • The potential to develop psychotic symptoms, such as paranoia, delusions, and hallucinations

Rohypnol 

Pills In Pill Bottle On White BackgroundRohypnol, also known as flunitrazepam, is a drug in the benzodiazepine class. It is an immediate-acting benzodiazepine that is useful to treat anxiety, seizures, and restless leg syndrome, and it can be used as a muscle relaxant or sedative. All of the drugs in the benzodiazepine class have a moderate potential for abuse and physical dependence. Empirical research has consistently shown withdrawal from benzodiazepines like Rohypnol to occur in two stages based on the intensity of symptoms and their duration:

Acute withdrawal following discontinuation of Rohypnol can be expected to occur within 3-4 days following last use of the drug. Acute withdrawal typically consists of anxiety and symptoms associated with anxiety. This anxiety is often labeled as rebound anxiety, as the anxiety represents a symptom controlled by the drug when the drug was used and returns once the person stops using the drug. Rebound anxiety and other symptoms will induce cravings during this period. Other intense symptoms such as flulike symptoms, increased blood pressure, increased heart rate, difficulty sleeping, nausea, vomiting, irritability, weight loss, and insomnia can accompany the anxiety. There is a potential for the development of seizures as well, and these can be potentially fatal. As a result, the person should be given immediate medical attention.

Protracted withdrawal occurs following the acute anxiety rebound phase, and in most individuals, it lasts 10-14 days. Milder manifestations of nausea, vomiting, shakiness, depression, anxiety, and cravings will continue over this time period.

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