Drug Addiction Treatment Programs & Alcohol Detox

[content-overview]

<strong>The term “alcoholism” is commonly used in American society, but it is a nonclinical descriptor.</strong> Unlike laypersons, researchers, doctors, therapists, and a host of other professionals require a consensus on what constitutes the different levels of alcohol use. The <a href="http://www.psychiatry.org/psychiatrists/practice/dsm/dsm-5" target="_blank" rel="noopener"><em>Diagnostic and Statistical Manual of Mental Disorder-5</em></a><em> (DSM-5)</em>, a publication of the American Psychiatric Association, provides professionals in the mental health field with an indispensable diagnostic tool that helps them to identify the various mental health disorders, including alcohol use disorder. [/content-overview]
<h2>What Is Alcohol Use Disorder?</h2>
According to the <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a>, in 2012, an estimated 7.2 percent of American adults aged 18 and older, approximately 17 million people, had a diagnosable alcohol use disorder. Men have alcohol use disorder almost twice as often as women; of the estimated 17 million affected adults, 11.2 million were men and 5.7 million were women. Adolescents are not immune. In 2012, an estimated 855,000 young people between 12-17 years of age had this disorder.

No two individuals who experience alcohol abuse are the same; however, DSM-5 provides clinicians with a set of <a href="http://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf" target="_blank" rel="noopener">11 factors</a> that can guide them in the diagnosis of an alcohol use disorder and its severity grade. In short, if a person has experienced at least two of the 11 factors (or symptoms) in the past year then the person is considered to have an alcohol use disorder. The existence of two or three symptoms equals a diagnosis of mild alcohol use disorder, while four to five symptoms is considered moderate, and six or more is considered severe.

[callout]
<strong>Ready to get help?</strong>Take a short quiz of DSM-5 criteria to assess the severity of your alcohol use.
<h4><strong><a href="https://americanaddictioncenters.org/self-assessment" target="_blank" rel="noopener">Take Self-Assessment</a></strong></h4>
[/callout]

To provide insight into the alcohol use diagnostics process, consider the following sample of four possible symptoms:
<ul>
 	<li><a href="/alcoholism-treatment/family-marital-problems/">An interference with work, school, family, and/or other responsibilities as a result of alcohol consumption</a></li>
 	<li>Continuing to consume alcohol despite the negative impact it is having on one's relationships</li>
 	<li>Engaging in risky behavior after drinking, such as fighting, driving, swimming, having unprotected sex, or operating machinery</li>
 	<li>Over time, requiring more alcohol to achieve the desired intoxicating effects</li>
</ul>
<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/StagesOfAlcoholism.png"><img class="aligncenter size-full wp-image-56648" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/StagesOfAlcoholism.png" alt="what are the stages of alcoholism" width="700" height="3098" /></a>

Overall, the 11 factors address both the physical and psychological components of alcohol use disorder. The distinction between physical dependence and psychological addiction is an important one to understand. As the <a href="http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence" target="_blank" rel="noopener">National Institute on Drug Abuse</a> explains, physical dependence is a component of addiction, but it is not synonymous with addiction. In other words, a person can be physically dependent on alcohol or another drug of abuse without being psychologically dependent on it.

There are two main hallmarks of physical dependence. First, the body will build a tolerance, which is a natural process. As tolerance builds, a person who consumes alcohol will require a higher volume in order to experience the familiar effects. Second, the body will go through withdrawal if intake of the familiar drug ceases or if there is a significant reduction in the usual amount. When a chronic alcohol abuser stops drinking the signs of withdrawal will set in. They may continue to drink in order to avoid feeling such symptoms.

Individuals with an alcohol use disorder (alcoholism) will likely experience the symptoms of physical dependence as well as psychological effects.

Withdrawal symptoms include: anxiety, confusion, tremors, racing heart, nausea, vomiting, and/or sleeplessness.
The psychological component of addiction does not refer to the effects alcohol has on one's mental state, such as disordered thinking. Rather, it refers to how the person's thoughts and actions become geared toward obtaining alcohol and consuming it, even to the exclusion of important responsibilities.
<h2>Early Alcohol Abuse</h2>
In terms of the DSM-5, new alcohol users could display 0-2 of the 11 symptoms discussed. The difficulty is that one never knows if social or occasional drinking will lead to the development of alcohol use disorder. In the <a href="http://www.healthline.com/health/stages-alcoholism#Alcoholism1" target="_blank" rel="noopener">early phases of alcohol abuse</a>, a person will usually get an introduction to different types of alcohol and experiment with alcohol in various forms.

Most often, these experimenting individuals are either high school students or young adults, such as college students. Drinking is usually a social event among this younger set, and they collectively binge drink as a way of partying. They may not be regular drinkers, but binge drinking alone still puts them at risk of developing alcohol use disorder. According to the National Institute on Alcohol Abuse and Alcoholism, <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking" target="_blank" rel="noopener">binge drinking</a> occurs when, within two hours, a person reaches a blood alcohol content of 0.08 or greater. For women, depending on body weight, this usually requires four drinks, and in men, it requires five drinks in 2 hours. However, many binge drinkers will exceed the four or five drink mark and experience higher levels of BAC as well as a host of debilitating physical and mental side effects.

Some binge drinkers or party drinkers will not progress beyond the experimental phase to drink regularly. Those who do continue to drink heavily or regularly may do so because they are environmentally or genetically predisposed to do so. For instance, <a href="http://pubs.niaaa.nih.gov/publications/FamilyHistory/famhist.htm" target="_blank" rel="noopener">children of people with an alcohol use disorder</a> are four times more likely to also experience this disorder. Further, research suggests that certain elements of a child's home life can dispose them to alcohol abuse, such as seeing a parent abuse alcohol or other drugs, or being exposed to a parent's depression or conflict/violence in the family. Additionally, some people have an existing mental health disorder, and they may graduate from social drinking to more frequent drinking because they perceive it relieves some of their psychiatric symptoms.
Environmental and genetic factors aside, the sheer number of drinks people consume in a given period of time can put them at risk for developing an alcohol use disorder. Women who have a daily intake of more than three drinks, or more than seven per week, are considered at risk. Men, due to their physiological differences from women, are considered to be at risk if they partake in more than four drinks a day or more than 14 per week.
<h2>Problematic Alcohol Abuse</h2>
Moderate use of alcohol is associated both with the frequency of consumption as well as the intention around drinking. A person who has an emotional or psychological attachment to drinking may be at a higher risk for developing an alcohol use disorder compared to a person who regularly has a glass of wine with a meal.

Generally, problem drinking is associated with the loss of control over one's alcohol intake and/or displaying signs that alcohol consumption is interfering with one's normal life activities. In such a case, in terms of the DSM-5 factors discussed, the person would begin to show more symptoms, possibly 3-5. At this stage, a person may or may not be physically dependent on alcohol. In other words, the cessation of drinking will lead to withdrawal symptoms.

<img class="aligncenter wp-image-32869 size-large" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/dramatic-image-of-a-sad-woman-59686475-1024x684.jpg" alt="sad girl high on suboxone pills" width="1024" height="684" />

However, if a person has an attachment to drinking, such as relying on it to “have a good time,” they may develop problematic drinking habits and eventually develop an AUD. <a href="/alcoholism-treatment/physical-health/">If alcohol dependence sets in, it will likely be more difficult to stop drinking because of the presence of withdrawal symptoms </a>and possibly cravings for alcohol.

Most addiction professionals agree that an at-home detox or “going cold turkey” is never advisable. The best practice would be to talk with an addiction counselor or mental health professional about safe options to detox from alcohol.

The need for a medically supervised detox depends, in part, on the length of time of alcohol abuse and usual volume of consumption. In some cases, alcohol withdrawal can present heightened risks and even lead to fatality. Individuals who are at risk for withdrawal effects require supervised medical detox. As a result, it is recommended that anyone seeking to detox from alcohol consult a medical professional first.
<h2>Severe Alcohol Abuse</h2>
A review of the 11 factors set forth in the DSM-5 regarding severe alcohol use disorder (i.e., the presence of six or more factors) provides additional insight into this condition. Having six or more of the alcohol use disorder symptoms would indicate the need for a treatment intervention to address the addiction.

Before discussing the negative outcomes associated with alcohol (i.e., its possibly devastating effects on one's life, including poor health, conflict in relationships, troubled finances, and precarious employment status) consider the class of heavy drinkers known as "highly functioning." A <a href="http://www.webmd.com/mental-health/addiction/features/high-functioning-alcoholic" target="_blank" rel="noopener">highly functioning person who abuses alcohol</a> will be able to work every day, exceed expectations, and meet all required financial obligations.

An estimated 20 percent of individuals who abuse alcohol may be classified as highly functioning. Continued drinking, however, is essentially a ticking time bomb. In terms of the negative fallout associated with heavy chronic drinking, despite appearances to the contrary, a highly functioning individual is not immune.

The development of negative health conditions and diseases is a major concern surrounding alcohol abuse. Health troubles can range in severity, but the following health conditions and diseases may manifest due to chronic, heavy alcohol abuse:
<ul>
 	<li>Cardiovascular disease</li>
 	<li>Anemia</li>
 	<li>Dementia</li>
 	<li>Cirrhosis</li>
 	<li>Cancer</li>
 	<li>Seizures</li>
 	<li>Depression</li>
 	<li>High blood pressure</li>
 	<li>Nerve damage</li>
 	<li>Pancreatitis</li>
 	<li>Gout</li>
 	<li>Infectious diseases</li>
</ul>
In some cases, alcohol abuse may exacerbate conditions but not cause them. In other cases, alcohol may be a component cause of a condition, and ongoing alcohol use will cause flare-ups. For instance, alcohol abuse can be a component cause of gout and worsen the condition.

Alcohol has been found to be directly causally related to some diseases and conditions, such as mouth cancer in a person with a history of heavy chronic drinking. In the unfortunate event that a chronic drinker develops a serious health condition or disease, the treating physician can explain whether alcohol was a direct cause or a component cause. The attending physician can also explain how continued drinking will impact the specific condition(s) present.
<h2>End-Stage Alcohol Abuse</h2>
In <em>One Flew Over the Cuckoo's Nest</em>, celebrated author Ken Kesey insightfully communicated the extreme cost that drinking can have on a chronic user's life when Chief Bromden described the last time he saw his father, “He was blind and diseased from drinking. And every time he put the bottle to his mouth, he didn't suck out of it, it sucked out of him.” This quote artistically communicates a truth about alcohol abuse; in end-stage alcohol abuse, a person loses control over alcohol use and actually becomes controlled by it.
The end stage may be thought of as the most severe articulation of all the possible problems associated with alcohol use disorder. It is a circumstance of reversals; rather than living to drink, a person in the end stage likely drinks to live. At this point, individuals have lost the ability to stop themselves from drinking. After a long enough period of heavy chronic alcohol use, withdrawal symptoms may be so painful that the person is motivated to continually drink just to prevent them.

At this point, an individual may develop a serious disease, such as cirrhosis of the liver. Cirrhosis of the liver emerges from years of liver damage. As individuals continually consume alcohol, their liver produces scar tissue instead of new healthy tissue. Over time, the scar tissue in the liver prevents the necessary flow of blood. The presence of scar tissue also impairs the body's ability to clean toxins from the blood, control infections, process nutrients, and absorb cholesterol and certain vitamins.In addition to chronic health diseases and conditions, persons in the end stage of alcohol abuse may be at a heightened risk of falls and other accidents due to balance and coordination problems. Most often, when death occurs after a fall, it is due to bleeding in the brain and not the fall itself.
A person in the end stage of alcohol abuse is also at risk for intentional self-harm. The loss of control over alcohol consumption can leave a person feeling powerless. Withdrawal, as stated, can be painful. The end stage alcohol abuse is in a true quagmire. Help is always available, as the depression associated with alcohol abuse can lead individuals to end their lives.

[callout-complex title="Getting Help" image="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/detox-help-1024x547.jpg" alt="Doctor hands writing on a clipboard."]

Alcohol abuse can have harrowing and hazardous side effects at every phase; however, <a href="/alcoholism-treatment/">each stage of alcohol abuse is treatable.</a> Even if certain chronic conditions cannot be reversed, abstinence can help to better manage them. Achieving sobriety is always a win for a person's health and wellbeing whether treatment occurs in the early, middle, or end stage. It's never too late to get help and achieve recovery.

Alcohol abuse is never exclusively about alcohol. For this reason, a full spectrum of rehab services that starts with medical detox and continues to treat the psychological aspects of abuse is needed.
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Stages of Alcoholism: Early, Chronic and End Stage

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<h4 class="text-elegant text-center no-margin-v">How Does Alcohol Impact Cognitive Ability?</h4>
[link-bank position="left" title="Occasional and moderate drinkers:"]
<ul>
 	<li>Memory impairment</li>
 	<li>Blackout</li>
 	<li>Recklessness</li>
 	<li>Impaired decision-making</li>
</ul>
[/link-bank]

[link-bank position="right" title="Heavy and/or chronic drinkers:"]
<ul>
 	<li>Diminished gray matter in the brain</li>
 	<li>Inability to think abstractly</li>
 	<li>Loss of visuospatial abilities</li>
 	<li>Wernicke-Korsakoff syndrome</li>
 	<li>Memory loss</li>
 	<li>Loss of attention span</li>
</ul>
[/link-bank]

[/callout]

<strong>Alcohol is an integral part of the American social scene. The failed experiment of Prohibition demonstrated the formidable demand Americans have for alcohol.</strong>
As advertisements caution, alcohol is meant to be enjoyed responsibly; however, alcohol consumption can cause individuals to lose their ability to think responsibly.

Alcohol is associated with a host of familiar <a href="https://dontbottleitup.org.uk/facts-about-alcohol/short-term-effects-of-alcohol/" target="_blank" rel="noopener">cognitive changes</a>, such as a loss of inhibitions, confused or abnormal thinking, and poor decision-making. Recreational alcohol users generally recover from its effects without any long-term problems. However, even short-term loss of control over normal mental functioning can result in legal and personal troubles that would likely not have occurred if alcohol were not involved. Alcohol consumption continues to maintain a foothold so strong in American culture that it is nearly impossible to imagine life without it.

[callout]
<h2>What Is Alcohol?</h2>
As the <a href="http://www.drugabuse.gov/drugs-abuse/alcohol" target="_blank" rel="noopener">National Institute on Drug Abuse</a> explains, the active ingredient in beer, wine, and liquor is ethyl alcohol, or ethanol, which is known colloquially as alcohol.
The process known as <a href="http://www.alcoholandyou.org.uk/facts/howisitmade.html" target="_blank" rel="noopener">fermentation</a> produces alcohol. When yeast is fermented, sugar breaks down into carbon dioxide and alcohol. Carbon dioxide exits the process through gas bubbles and leaves behind a combination of water and ethanol. The process is so precise that if any air is present in the yeast, the result will be ethanoic acid, a chemical found in common vinegar.

Alcohol is basically made from sugar and yeast, but different sources of sugar can produce different types of alcohol. For instance, the sugar from grape pulp is combined with yeast to create either red or white <a href="http://winefolly.com/review/how-wine-is-made-in-pictures/" target="_blank" rel="noopener">wine</a>. In the case of <a href="http://blog.beeriety.com/2009/07/06/how-beer-is-made/" target="_blank" rel="noopener">beer</a>, the source of the sugar is usually barley, but it can also be other grains, such as wheat or rye. To release the sugars, the grains must be malted, mashed, and boiled. Once the sugars are ready for use, yeast is added and the fermentation process begins. Different liquors are made different ways. When it comes to <a href="http://www.livescience.com/41298-what-is-vodka.html" target="_blank" rel="noopener">vodka</a>, for example, there is a popular belief that potato is usually the source of the sugar; however, the majority of vodka is made from fruit, barley, wheat, sorghum, or corn.

Alcohol products, such as wine, beer, and liquor, are made in commercial distilleries, but the process of making DIY alcohol (<a href="http://science.howstuffworks.com/innovation/edible-innovations/moonshine3.htm" target="_blank" rel="noopener">moonshine</a>) still relies on the basics discussed above. In some parts of the world, such as Scandinavian Europe and Russia, moonshine is a popular and low-cost alternative to commercial alcohol in some locales. Moonshine is known for its potency, which can be dangerous. Moonshine can be 150-proof, which translates into it being 75 percent alcohol. An added hazard is that it is not created in a regulated setting; therefore, there are fewer, if any, quality and safety guarantees. Although there is not a pressing public concern about rampant sales of moonshine, there are <a href="http://www.daytondailynews.com/news/news/local-education/13-year-old-builds-moonshine-still-for-class-teach/nkM5k/" target="_blank" rel="noopener">reports of Americans making DIY alcohol</a> and finding themselves in legal hot water as a result. For instance, a 51-year-old man was arrested in Ohio after selling moonshine out of his camper at a fair. The man's ostensible motive was to make a profit. The Ohio court ordered the moonshine maker to pay an $800 penalty and required him to complete 50 hours of community service.

Making moonshine may sound antiquated to modern ears, but it demonstrates the relative ease with which alcohol can be illegally made. Although some Americans still have Prohibition sympathies, the ability to home-produce alcohol serves as a reminder that it would likely be impossible to entirely remove alcohol from the American landscape.

[/callout]
<h2>Alcohol Consumption in the US</h2>
The <a href="http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf" target="_blank" rel="noopener">National Survey on Drug Use and Health</a> is a key source of information about the patterns of alcohol and other drug use in America. The 2013 survey made the following estimated findings with respect to alcohol consumption:
<ul>
 	<li>About 52.2 percent of Americans aged 12 or older were current alcohol users.</li>
 	<li>Approximately 6.3 percent of the population aged 12 or older (16.5 million) were heavy alcohol users.</li>
 	<li>In the past 30 days, 22.9 percent of the population aged 12 or older (60.1 million) reported binge drinking behavior.</li>
 	<li>About 10.9 percent of Americans aged 12 or older reported that they had driven a car under the influence at least once in the past year.</li>
 	<li>Approximately 8.7 million Americans under the legal drinking age (12-20 years of age) were current alcohol users. This statistic includes 5.4 million binge drinkers and 1.4 million heavy drinkers.</li>
</ul>
Alcohol is the most commonly abused drug in the US, with marijuana occupying second place. Despite the known dangers of excessive alcohol consumption, these statistics clearly reflect that many alcohol users engage in heavy use and binge drinking. Further, despite the well-known fact that alcohol impairs brain functioning, an estimated one in 10 Americans aged 12 or older operated a vehicle under the influence. This statistic demonstrates that only a fraction of those who drive under the influence are actually detected.

[quote]It is well established in the mental health field that alcohol consumption can exacerbate an underlying mental health disorder.[/quote]

In the field of substance abuse treatment, an individual who simultaneously has a substance use disorder and at least one other mental health disorder is considered to have a dual diagnosis. Whether alcohol causes or simply accompanies the underlying mental health disorder is not clearly understood. However, there is general consensus that <a href="/alcoholism-treatment/">individuals who abuse alcohol and have a mental health disorder diagnosis require treatment for both conditions.</a>

[callout]
<h2>Alcohol in the Brain</h2>
<img class="alignleft size-medium wp-image-22025" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/CNS-depressants-300x202.jpg" alt="Brain Model" width="300" height="202" />

While it is true that alcohol can initially perk people up and even help them to socialize at a party, alcohol is a central nervous system depressant. The depressant effects of alcohol are witnessed when people who have been drinking have slurred speech and poor limb coordination that prevents them from being able to walk properly. Although these outward signs of intoxication can be easily observed, it isn't as clear how alcohol acts on a deeper level inside the body. So, <a href="http://science.howstuffworks.com/life/inside-the-mind/human-brain/alcoholism4.htm" target="_blank" rel="noopener">how does alcohol act at the neurological level</a>?
Alcohol acts on the receptor sites for the neurotransmitters (chemical messengers) known as GABA, glutamate, and dopamine. Alcohol's activity on the GABA and glutamate sites results in the <a href="/alcoholism-treatment/physical-health/">physiological effects associated with drinking</a>, such as a slowing down of movement and speech. Alcohol's activity on the dopamine site in the brain's reward center produces the pleasurable feelings that motivate many people to drink in the first place.

As a <a href="https://www.psychologytoday.com/blog/you-illuminated/201006/your-brain-alcohol" target="_blank" rel="noopener">Psychology Today</a> article on this topic discusses, the degree to which alcohol impacts a person's mood, behavior, and neurological functioning depends in part on whether the blood alcohol content (BAC) is elevating or decreasing. With 1-2 drinks, the person may feel excited or more talkative, but with more and more alcohol in their system, they become more sedated and being to lose control of their movement and may experience impaired thinking and memory. The fluctuation in BAC helps to account for why the same person can go from being the life of the party to needing help with basics, like walking.
In addition, the following factors have been shown to influence how alcohol impacts a person's brain functioning over time:
<ul>
 	<li>The volume a person drinks</li>
 	<li>How often a person drinks</li>
 	<li>The age at which drinking began</li>
 	<li>The number of years a person has been drinking</li>
 	<li>The person's sex, age, and genetic factors</li>
 	<li>Whether the person's family has a history of alcoholism</li>
 	<li>Whether the person was exposed to alcohol as a fetus</li>
 	<li>The person's general health condition</li>
</ul>
When considering the negative consequences of alcohol, people often think of what can happen in public, such as getting into a car accident or an alcohol-induced altercation. However, people play a game of roulette with themselves when they drink, especially when they drink heavily, because the effects of alcohol on the brain are uncertain both in the short-term and long-term. If other drugs are added to the alcohol consumption, the risks become more serious.

[/callout]

[callout]
<h4>More about the Effects on the Brain or Body</h4>
<ul>
 	<li><a href="/alcoholism-treatment/body-effects">Alcohol on the Body</a></li>
 	<li><a href="/benzodiazepine/mental-physical-effects">Benzodiazepines</a></li>
 	<li><a href="/blog/crystal-meth-effect-body">Crystal Meth</a></li>
 	<li><a href="/ecstasy-abuse/mental-and-physical-effects/">Ecstasy</a></li>
 	<li><a href="/heroin-treatment/effects/">Heroin</a></li>
 	<li><a href="/cocaine-treatment/effects-on-the-brain/">Cocaine</a></li>
 	<li><a href="/meth-treatment/effects-on-the-brain-and-cns/">Meth</a></li>
 	<li><a href="/methadone-addiction/effects-on-the-brain-and-body/">Methadone</a></li>
 	<li><a href="/morphine-treatment/mental-and-physical-effects/">Morphine</a></li>
</ul>
[/callout]

<a name="Occasional Drinkers"></a>
<a name="Moderate Drinkers"></a>
<h2>Occasional Drinkers</h2>
In occasional drinkers, alcohol can produce one or more short-term effects after one or more drinks. Memory impairment can begin after a few drinks, and it can become increasingly worse as the consumption increases. A high volume of alcohol consumption, especially on an empty stomach, can result in a blackout. Occasional drinkers will usually recover from a blackout without any lasting mental problems. However, there are numerous dangers associated with acute alcohol intoxication, such as engaging in reckless activities like unprotected sex, vandalism, and driving. Further, an alcohol-involved incident, such as a car accident, can cause ongoing problems as court dates will need to be attended, fines must be paid, and educational or treatment requirements will have to be met.
<h2>Moderate Drinkers</h2>
As the <a href="http://www.cdc.gov/alcohol/faqs.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a> discusses, the <em>Dietary Guidelines for Americans</em> considers a moderate drinker to be a person who consumes one drink (applies to women) or two drinks (applies to men) per day. Despite extensive news coverage of medical reports that moderate drinking has positive health benefits, the guidelines advise that this is not a reason to start drinking. Moderate alcohol consumption has negative associations, such as increasing the risk of breast cancer and causing violence, falls, drownings, and car accidents. Moderate drinking does not insulate a person from the cognitive impairment associated with drinking and the dangerous consequences that can result.

<a name="Heavy and Chronic Drinking"></a>
<h2>Heavy and Chronic Drinking</h2>
<img class="alignright size-medium wp-image-32835" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/Black-and-white-image-of-a-you-60258002-300x200.jpg" alt="blind girl on drugs" width="300" height="200" />

Unlike an occasional or moderate drinker, <a href="http://pubs.niaaa.nih.gov/publications/aa63/aa63.htm" target="_blank" rel="noopener">a person who drinks heavily</a> over an extended period of time may develop deficits in brain functioning that continue even if sobriety is attained. In other words, cognitive problems no longer arise from drinking alcohol but from brain damage that prior drinking caused. In short, long-term alcohol abuse can negatively impact the brain's “hard wiring” such that even when drinking ends, the cognitive problems persist.

According to the <a href="http://pubs.niaaa.nih.gov/publications/aa53.htm" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a>, most heavy long-term alcohol users will experience a mild to moderate impairment of intellectual functioning as well as diminished brain size. The most common impairments relate to the ability to think abstractly as well as the ability to perceive and remember the location of objects in two- and three-dimensional space (visuospatial abilities).

In addition, there are numerous brain disorders associated with chronic alcohol abuse. For example, research supports that up to 80 percent of chronic alcohol users have a thiamine deficiency, and some in this group will progress to a serious brain disorder known as Wernicke-Korsakoff syndrome (WKS). Symptoms of WKS include confusion, paralysis of eye nerves, impaired muscle coordination, and <a href="/learning-disorders/">persistent problems with memory and learning ability</a>.

Fortunately, certain types of cognitive impairment can be reversed through abstinence from alcohol. Studies show that those who have recently undergone medical detox exhibit mild but significant improvement in certain cognitive abilities, especially those related to visuospatial tasks, problem-solving abilities, and short-term memory. Through ongoing abstinence, over a period of several months to one year, a recovering individual will continue to improve cognitive skills, such as visuospatial abilities, working memory, and attention span. In addition, research shows that brain volume can increase with abstinence.

Short and Long Term Mental Effects of Alcohol

[callout title="
<h2>What Are Some Side Effects of Ambien?</h2>
"]
Ambien (generic name: zolpidem tartrate) was designed to provide insomnia relief, without the <a href="https://americanaddictioncenters.org/barbiturate/side-effects">side effects of barbiturate drugs</a>. Ambien side effects include:
[columns count="3"]
<ul class="text-sm">
 	<li>Rapid heartbeat</li>
 	<li>Nausea</li>
 	<li>Vomiting</li>
 	<li>Diarrhea</li>
 	<li>Loss of appetite</li>
 	<li>Impaired vision</li>
 	<li>Slow breathing rates</li>
 	<li>Muscle cramps</li>
 	<li>Allergic reactions</li>
 	<li>Memory loss</li>
 	<li>Inability to concentrate</li>
 	<li>Disorientation</li>
 	<li>Emotional blunting</li>
 	<li>Depression and/or suicidal thoughts</li>
 	<li>Anxiety</li>
 	<li>Insomnia</li>
 	<li>Nightmares</li>
 	<li>Sedation</li>
 	<li>Confusion</li>
 	<li>Dizziness</li>
 	<li>Aggression</li>
 	<li>Addiction</li>
</ul>
[/columns]

[/callout]

<b>Finding a medication that provides satisfying sleep without serious side effects can be challenging.</b>

<img class="alignright size-full wp-image-33459" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/what-are-ambien-side-effects.jpg" alt="what-are-ambien-side-effects" width="350" height="300" />

Many widely used sleep medications, including benzodiazepines like Valium and barbiturates like Nembutal, can cause daytime drowsiness, over-sedation, and chemical dependency. In the 1990s, Ambien, or zolpidem tartrate, was designed to offer the benefits of other hypnotic drugs without some of the more severe side effects. Ambien has since become one of the most popular sleep medications, ranking at number 15 on the list of the most frequently prescribed drugs in the country, according to <a href="https://www.imshealth.com/deployedfiles/imshealth/Global/Content/StaticFile/Top_Line_Data/2010_Top_Products_by_RX.pdf" target="_blank" rel="noopener">IMS Health</a>.

At its introduction, Ambien was touted as a safe short-term sleep aid, lacking the risks of narcotic sedatives. But now that Ambien has been available to the public for over 20 years, the more serious side effects of this medication have come to light. Understanding these side effects can help consumers make informed decisions about using hypnotic drugs and may discourage nonmedical users from taking this drug recreationally.

[callout title="<h2>Physical Side Effects</h2>"]
When taken as directed, Ambien calms the activity of the brain and nerves, making it easier for the user to fall asleep. At the same time, Ambien can have serious side effects on the cardiovascular, respiratory, digestive, and sensory systems. Some of the potential reactions to Ambien include:

[columns count="2"]
<ul>
 	<li>Rapid or irregular heartbeat</li>
 	<li>Nausea and vomiting</li>
 	<li>Abdominal pain</li>
 	<li>Diarrhea</li>
 	<li>Appetite loss</li>
 	<li>Double vision</li>
 	<li>Pinpoint pupils</li>
 	<li>Respiratory depression</li>
 	<li>Muscle cramps</li>
 	<li>Skin rashes</li>
 	<li>Abnormal body movements</li>
</ul>
[/columns]

Some users have had a life-threatening allergic reaction to zolpidem.

[quote]Symptoms of an allergic response include hives, shortness of breath, and swelling of the face, lips, mouth, or tongue. An allergic reaction requires emergency medical treatment.[/quote]

[/callout]
<h2>Cognitive Impairment</h2>
<img class="alignright size-full wp-image-32477" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/boosting_brain.jpg" alt="cognitive impairment " width="220" height="150" />

Ambien is categorized as a non-benzodiazepine hypnotic medication. The chemical structure of this drug was designed to reproduce the effects of benzodiazepines on the central nervous system without the potential for abuse or addiction. Like benzodiazepines, Ambien acts on receptor cells in the brain that bind with GABA (gamma-aminobutyric acid), a brain chemical that influences sleep and other neurological activities. Some users have experienced negative cognitive or psychological side effects to Ambien, such as:
[columns count="2"]
<ul>
 	<li>Memory loss</li>
 	<li>Difficulty concentrating</li>
 	<li>Disorientation to place or time</li>
 	<li>Loss of emotional affect</li>
 	<li>Loss of pleasure in daily life</li>
 	<li>Depression</li>
 	<li>Suicidal thoughts or suicide attempts</li>
 	<li>Anxiety</li>
 	<li>Sleep disturbances</li>
 	<li>Nightmares</li>
</ul>
[/columns]

Although Ambien was originally intended to produce less drowsiness than other sleep medications, recent research has shown that at higher doses, the drug can remain active in the individual the morning after it is taken. The U.S. Food and Drug Administration (FDA) recently issued a warning about the possibility of “next-morning” impairment after taking Ambien. The FDA found that in some users, blood tests revealed that there was enough Ambien in the system to cause impairment at tasks that require mental alertness and coordination, such as driving. To reduce the risk of this side effect, the FDA recommends that prescribers limit the dose of the drug, especially for women.
Individuals who take Ambien for nonmedical reasons are at risk of experiencing an intensification of adverse side effects, including the following:

[columns count="2"]
<ul>
 	<li>Excessive sedation</li>
 	<li>Confusion and disorientation</li>
 	<li>Lack of motor coordination</li>
 	<li>Slow response times</li>
 	<li>Delayed reflex reactions</li>
 	<li>Dizziness</li>
 	<li>Hallucinations</li>
 	<li>Impaired judgment</li>
 	<li>Aggression</li>
</ul>
[/columns]

Although Ambien is classified as a sedative, this drug can give the user a rush of energy and euphoria when it is abused at high doses. However, misusing this drug can result in extreme drowsiness, confusion, and clumsiness, all of which increase the risk of falls, fractures, and other accidental injuries. The National Highway Traffic Safety Administration reports that users who take Ambien to the point of intoxication may experience sedation for up to 16 hours after taking the drug. Taking Ambien with other drugs that depress the central nervous system, such as alcohol, opioid pain medications, or tranquilizers, intensifies the sedative effects of Ambien and heightens the risk of overdose or injury.

Depression and suicidal thoughts have been observed in some individuals who have taken Ambien. The <em><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878174/" target="_blank" rel="noopener">DARU Journal of Pharmaceutical Sciences</a></em> presents a case report of a young man who became depressed and attempted suicide after taking Ambien. He had no known history of mood disorders or past suicide attempts. The FDA cautions that individuals with a history of depression may experience a worsening of their depressive symptoms and an increase in suicidal thoughts after taking Ambien.
<h2>Sleepwalking and Other Activities</h2>
After taking Ambien before going to sleep, some individuals have experienced episodes of sleep walking and other unconscious behaviors. These activities include eating, driving, having sex, and holding conversations with other people. In these reported cases, the individuals were unaware of these activities while they were occurring.
Case studies published in the <em><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762721/" target="_blank" rel="noopener">Journal of Clinical Sleep Medicine</a> </em>indicate that some patients have experienced a behavior called sleep eating disorder, or night eating disorder, after taking Ambien. These individuals woke to find evidence that they had consumed food during the night, but they had no memory of doing so. Other patients reported having complete conversations, leaving their homes to walk through the neighborhood, or even waking up behind the wheel with no memory of driving. One woman had alarms installed on the doors of her home to alert her family if she tried to leave the house while sleeping.

[quote]For some users, sleep behaviors can be corrected by reducing the dose of Ambien, but in extreme cases, the drug may have to be discontinued in order to prevent the behavior.[/quote]

[callout]
Although Ambien and other sedative-hypnotics are still widely prescribed as short-term treatments for insomnia, the <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/019908s027lbl.pdf" target="_blank" rel="noopener">Food and Drug Administration (FDA)</a> changed prescribing guidelines in 2012 to cut the recommended lowest dose in half.
[/callout]

<img class="alignright size-full wp-image-44388" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/ambien-blackout.jpg" alt="Ambien: Dangers of Blackouts" width="375" height="248" />

This is after numerous reports of users participating in dangerous activities, including driving, having sex, and eating, while they were reportedly asleep. These instances are sometimes called <a href="http://www.webmd.com/sleep-disorders/news/20060315/ambien-linked-to-sleep-eating#1" target="_blank" rel="noopener">Ambien blackouts</a>: The person performs activities after they have taken Ambien, although they do not remember them. The clinical term, however, is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762721/" target="_blank" rel="noopener"><em>parasomnia</em></a> – an activity like walking, eating, talking on the phone, and others, which occurs after a person has gone to sleep.

There are certainly reports of sleepwalking, sleep-eating, and sleep-driving that do not involve Ambien and other prescription sleep aids, but the addition of Ambien appears to induce these behaviors in people who do not normally have them and may potentially make them worse in people who do have parasomnias.
<h2 style="text-align: center;">Sleep-Driving</h2>
Ambien can induce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227709/" target="_blank" rel="noopener">complex behaviors</a> while asleep. The most famous of these is sleep-driving, which has led to legal problems for people who take Ambien, whether as prescribed or for recreational reasons. The FDA notes that use of alcohol and other drugs <a href="/health-complications-addiction/nervous-system/">that depress the central nervous system</a> (including prescribed opioid painkillers) increases the risk of parasomnias, especially more complex and dangerous ones like sleep-driving. The person will get out of bed, get into their car, and begin driving as normal, without being awake or fully awake; the person will not remember the incident and may only be aware of the incident if they are pulled over and arrested for intoxicated driving.

The National Highway Traffic Safety Administra<a href="https://one.nhtsa.gov/people/INJURY/research/job185drugs/zolpidem.htm" target="_blank" rel="noopener">tion (NHTSA)</a> reports that the first four or five hours after consuming Ambien involves cognitive and motor coordination impairment, whether the person is asleep or not.
<h2 style="text-align: center;">Sleep-Eating</h2>
[callout]

Sleep-eating is another dangerous activity that people may perform while experiencing an Ambien blackout. Without remembering, a person may get out of bed and eat; while this could be harmful for people who are trying to lose weight or who have a regulated diet for other health reasons, sleep-eating is also dangerous because the person may attempt to prepare food on the stove or in the oven, and hurt themselves or cause damage to their house.

[/callout]

A report in the <a href="http://wislawjournal.com/2006/04/26/ambien-users-wake-up-smell-the-lawsuits/" target="_blank" rel="noopener"><em>Wisconsin Law Journal</em> from 2006</a> notes that one woman sued the pharmaceutical company that manufactures Ambien because she ate dangerous items, including raw eggs and uncooked rice, on top of whole loaves of bread, numerous canned goods, and entire bags of chips and candy. She reportedly woke up vomiting from noxious combinations of food, developed an ulcer, and gained an unhealthy amount of weight very quickly.

[callout title="<h2>More on Drug Side Effects</h2>"]
<ul>
 	<li><a href="/adderall/side-effects">Adderall</a></li>
 	<li><a href="/ativan-treatment/side-effects">Ativan</a></li>
 	<li><a href="/barbiturate/side-effects">Barbiturates</a></li>
 	<li><a href="/benzodiazepine/mental-physical-effects">Benzodiazepines</a></li>
 	<li><a href="/fentanyl-treatment/side-effects/">Fentanyl</a></li>
 	<li><a href="/hydrocodone-treatment/side-effects/">Hydrocodone</a></li>
 	<li><a href="/klonopin-treatment/side-effects/">Klonopin</a></li>
 	<li><a href="/oxycodone/side-effects/">Oxycodone</a></li>
</ul>
[/callout]
<h2>Having Sex while Asleep</h2>
Having sex during an Ambien blackout may lead to contracting sexually transmitted infections (STI), including HIV and herpes. While people with partners or spouses are more likely to experience this parasomnia, it is possible that a person may take Ambien, sleepwalk, and initiate sexual contact with a stranger or acquaintance. If prophylactics are not used, then either person could contract an STI.

People who struggle with Ambien abuse and addiction may intentionally mix the drug with other intoxicating substances, such as alcohol, to enhance the euphoric effects. This means that they may experience more blackouts than other people, especially since alcohol can also cause blackouts or large patches of amnesia. During a blackout, people may accidentally harm themselves or others.
<h2 style="text-align: center;">Abuse, Addiction, and Withdrawal</h2>
Ambien was first developed to provide an effective alternative to other sleep medications, without the potential for abuse or addiction.

However, research has shown that Ambien can produce tolerance, dependency, and withdrawal — all signs of a potentially addictive drug. One of the most serious side effects of using Ambien is the possibility of becoming chemically dependent on the medication, or needing Ambien in order to feel comfortable and function normally.

If Ambien is taken according to a doctor's orders and used on a short-term basis, chemical dependency and addiction are unlikely to develop. <a href="/ambien-treatment/long-term/">Individuals at risk of addiction include those who take Ambien for longer than a few weeks</a>, those who take more than the recommended dose, and recreational users who abuse the drug for nonmedical reasons. Recreational users often take Ambien in unsafe ways, such as crushing the drug into a powder and mixing it with alcoholic beverages or snorting it. Taking Ambien this way significantly increases the risk of over-sedation, overdose, and addiction.

A case study published in the <em><a href="http://www.ncbi.nlm.nih.gov/pubmed/11154097" target="_blank" rel="noopener">Journal of Clinical Neuropharmacology</a></em> describes the experiences of a 43-year-old woman who experienced severe withdrawal symptoms after she stopped taking Ambien. The patient had misused the drug by taking it at excessively high doses. When the drug was discontinued too quickly, she experienced reactions similar to those associated with withdrawal from benzodiazepines, including seizures. This experience, and other studies that followed, indicate that the brain and body can become dependent on Ambien, and that a gradual dose reduction is required to prevent serious reactions after stopping the medication.

Additional withdrawal symptoms may include:

[columns count="2"]
<ul>
 	<li>Anxiety</li>
 	<li>Sleeplessness</li>
 	<li>Agitation</li>
 	<li>Dizziness</li>
 	<li>Headaches</li>
 	<li>Tremors</li>
 	<li>Nausea</li>
 	<li>Muscle cramps</li>
</ul>
[/columns]

With prescription drug abuse and addiction becoming more common, drug rehab programs have been developed to treat these conditions safely. A detox program for Ambien includes a medically monitored drug taper, in which the dose of the drug is lowered in small increments to prevent extreme physical or neurological reactions. After the detox phase, the therapeutic services of rehab can address the thought patterns and behaviors that underlie addiction.

No matter what an individual's level of Ambien abuse may be, rehab offers a way to recover physical and psychological health.

[callout title="<h2>What Are the Side Effects of Other Drugs</h2>"]
[columns count="2"]
<ul>
 	<li><a href="/adderall/side-effects/">Adderall</a></li>
 	<li><a href="/ativan-treatment/side-effects/">Ativan</a></li>
 	<li><a href="/barbiturate/side-effects/">Barbiturates</a></li>
 	<li><a href="/cocaine-treatment/long-term-side-effects-of-abuse/">Cocaine</a></li>
 	<li><a href="/fentanyl-treatment/side-effects/">Fentanyl</a></li>
 	<li><a href="/hydrocodone-treatment/side-effects/">Hydrocodone</a></li>
 	<li><a href="/inhalant-abuse/side-effects/">Inhalant</a></li>
 	<li><a href="/ketamine-abuse/long-term-side-effects/">Ketamine</a></li>
 	<li><a href="/klonopin-treatment/side-effects/">Klonopin</a></li>
 	<li><a href="/kratom/side-effects/">Kratom</a></li>
 	<li><a href="/lunesta-treatment/side-effects/">Lunesta</a></li>
 	<li><a href="/meth-treatment/side-effects/">Meth</a></li>
 	<li><a href="/methadone-addiction/side-effects/">Methadone</a></li>
 	<li><a href="/oxycodone/side-effects/">Oxycodone</a></li>
 	<li><a href="/phenobarbital-abuse/long-term-side-effects/">Phenobarbital</a></li>
 	<li><a href="/psychedelics/side-effects-of-dmt/">DMT</a></li>
 	<li><a href="/suboxone/side-effects/">Suboxone</a></li>
 	<li><a href="/tramadol-abuse/side-effects/">Tramadol</a></li>
</ul>
[/columns]

[/callout]

Serious Ambien Side Effects: Memory, Depression, and More

[content-overview]
Physical signs of marijuana use include red eyes, poor muscle coordination, delayed reaction times, and increased appetite. A sudden shift in mood from tense to relaxed could indicate marijuana use, as could abrupt symptoms of anxiety, panic, and/or hallucinations. Marijuana also has a distinctive smell, sometimes described as skunk-like. Catching a whiff of this scent on a person's clothing or hair could also be a sign that the person has used the drug recently.[/content-overview]

At home, at work, or in other places where sobriety is the norm, individuals who are high on marijuana may sometimes go unnoticed.

Oftentimes, people who notice a change in someone may second-guess their initial perception. As part of this process of doubting, people may attribute the concerning behavior to fatigue, illness, or even just an off mood.

<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/HowToTellWhenSomeoneIsHigh.png"><img class="aligncenter size-full wp-image-56635" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/HowToTellWhenSomeoneIsHigh.png" alt="How to tell when someone is high on marijuana" width="700" height="2957" /></a>

As the concerning behavior persists, it becomes more difficult for concerned individuals to deny that there may be a problem. <a href="/marijuana-rehab/child-using/">In order to informally investigate if drug abuse is occurring</a>, it's important to have an understanding of both physical and psychological signs of abuse.
<h2>The Effects of Marijuana on the Brain</h2>
Most Americans have a general idea about the side effects associated with marijuana use, and these effects are the result of <a href="http://headsup.scholastic.com/students/the-science-of-marijuana" target="_blank" rel="noopener">how marijuana acts on the brain</a>. THC is the short-form term for delta-9-tetrahydrocannabinol, which is the psychoactive chemical in marijuana. Blood carries THC to the brain where it acts on cannabinoid receptors (the complexes that interact with the cannabinoid neurotransmitter). Cannabinoids naturally occur in the body.

The general effect of cannabinoids on cannabinoid receptor sites is to slow down communications between the cells in the body and the brain. The presence of THC has a similar effect, which is why marijuana is often associated with a relaxing and calming effect. THC also triggers the brain's reward system, which results in the pleasurable effects associated with marijuana.
<h2>Signs of Use</h2>
The <a href="http://www.drugfreeworld.org/drugfacts/marijuana/short-and-long-term-effects.html" target="_blank" rel="noopener">short-term effects of marijuana use</a> are also signs of recent use. As the Foundation for a Drug-Free World notes, the following are some common physical side effects associated with marijuana use:
<ul>
 	<li>Panic</li>
 	<li>Anxiety</li>
 	<li>Poor muscle and limb coordination</li>
 	<li>Delayed reaction times and abilities</li>
 	<li>An initial liveliness</li>
 	<li>Increased heart rate</li>
 	<li>Distorted senses</li>
 	<li>Red eyes</li>
</ul>
<h2>Methods to Use Marijuana</h2>
A marijuana high can generally last up to a few hours. In general, the duration of the high will depend on the user's level of tolerance, the particular potency of the marijuana, and the way the drug was consumed. The following are some of the most popular ways marijuana is used:
<ul>
 	<li>Smoking it (in a bong or rolling papers)</li>
 	<li>In food as "edibles"</li>
 	<li>In teas</li>
 	<li>In hash or wax form</li>
 	<li>In a vaporizer</li>
 	<li>In tonics and tinctures</li>
</ul>
The consumption of marijuana-based edibles can increase the likelihood of adverse reactions. The THC in edibles takes longer to be absorbed into the blood than when marijuana is smoked. As a result, the individual who consumes edible forms of marijuana may overeat to compensate for the lag time in the high, which can be dangerous
<h2>Hazards of Use</h2>
The hazards are not limited to edibles. A high level of THC in the body can lead to <a href="https://www.nlm.nih.gov/medlineplus/ency/article/000952.htm" target="_blank" rel="noopener">acute marijuana toxicity</a>.

[quote]In some cases, the toxicity may owe to the marijuana alone, but some drug dealers mix other drugs into marijuana (such as hallucinogens).[/quote]

The substances added to marijuana may result in serious effects, such as:
<ul>
 	<li>Chest pain and heart rhythm irregularity</li>
 	<li>Hyperactivity and/or aggressiveness</li>
 	<li>Cardiac arrest</li>
 	<li>Heart attack</li>
 	<li>Headache and high blood pressure</li>
 	<li>Stroke</li>
 	<li>Seizures</li>
</ul>
<h2>Increased Potency</h2>
Marijuana is not only a popular drug; it is an evolving one. The <a href="http://www.drugabuse.gov/publications/drugfacts/marijuana" target="_blank" rel="noopener">National Institute on Drug Abuse</a> warns that the potency of marijuana has been on the rise for the last few decades. The increased potency mainly stems from the ability of marijuana cultivators to continually create new, more powerful strains.

The increased THC may result in uncommon and easily observable side effects. As <a href="http://www.cnn.com/2013/08/09/health/weed-potency-levels/" target="_blank" rel="noopener"><em>CNN</em></a> reports, Dr. Stuart Gitlow of the American Society for Addiction Medicine has found that approximately one in every 100 people who uses highly potent marijuana will manifest psychotic symptoms. Further, as <a href="http://www.foxnews.com/health/2015/02/17/smoking-high-potency-marijuana-may-cause-psychiatric-disorders/" target="_blank" rel="noopener"><em>Fox News</em></a> reports, one study found that smoking marijuana with high THC content can lead to the onset of psychiatric disorders.

[media image="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/07/Marijuana-1.jpg" alt="Marijuana on table"][/media]

These observations about super potent marijuana translate into guidance for concerned individuals. Sudden or uncharacteristic psychotic symptoms (e.g., a disconnection from reality) can be evidence of marijuana use (although it may separately be a sign of a mental health disorder). Psychiatric side effects may be more acute in a person who has an existing mental health disorder, but individuals without a diagnosis are not immune from severe reactions. It is important to note that super potent marijuana is not the same as “synthetic marijuana” (chemicals sprayed onto leaves and sold under various  names, such as Spice). According to <a href="http://www.livescience.com/19140-synthetic-marijuana-unusual-side-effects.html" target="_blank" rel="noopener">reports on synthetic marijuana</a> side effects, some users have experienced extreme aggression, the inability to speak, hallucinations, and/or general unresponsiveness.

Marijuana use may lead to addiction and/or physical dependence, despite popular belief that it won't. Regular users may begin to build a tolerance and require more of it to achieve the effects. With increasing and continued use, they may become dependent and experience withdrawal if they stop. They may also eventually become addicted.

Although marijuana withdrawal is generally considered to be mild, effects can include irritability or anxiety. In heavy users, <a href="http://www.webmd.com/mental-health/addiction/news/20080507/withdrawal-symptoms-from-smoking-pot" target="_blank" rel="noopener">marijuana withdrawal symptoms</a> can include cravings for marijuana, trouble sleeping, irritability, anxiety, and boredom.

[quote]To avoid these symptoms, or to get a reprieve from them, some people who thought they were done with marijuana decide to resume use.[/quote]
<h2>Finding Marijuana and Related Paraphernalia</h2>
Whether a concerned person finds paraphernalia accidentally or after a search, the discovery can confirm suspicions or alert individuals that drug use is occurring. It is critical to note that searching for drug paraphernalia can be construed as an invasion of privacy, but on balance with the hazards associated with marijuana abuse, it may be considered justified. The question then arises as to where to look. Individuals who are hiding marijuana use from the people with whom they reside can be very inventive.

The following is a partial list of some marijuana-specific types of paraphernalia:
<ul>
 	<li>Rolling papers (usually white or brown)</li>
 	<li>Pipes (various materials, such as glass)</li>
 	<li>Cigar papers (contents emptied)</li>
 	<li>Bongs</li>
 	<li>E-cigarettes (to smoke concentrates)</li>
 	<li>Roach clips</li>
</ul>
The following are some places where persons who use marijuana or other drugs may <a href="http://www.paysonroundup.com/news/2011/apr/22/addicts-get-creative-when-hiding-their-stash/" target="_blank" rel="noopener">hide drugs or paraphernalia</a>:
<ul>
 	<li>In a carved-out space at the top of a door</li>
 	<li>In over-the-counter drug packages</li>
 	<li>In an unopened soda can</li>
 	<li>In hollowed-out cans</li>
 	<li>Under a fish tank</li>
 	<li>In the lining of a speaker</li>
 	<li>In a drop ceiling</li>
 	<li>In the false roof of a bird house</li>
 	<li>In a wall outlet</li>
 	<li>Between slats of assembled furniture</li>
</ul>
Once marijuana or paraphernalia is discovered, the next issue will be determining its age or when it was last used. Old marijuana may have mold on it, be brittle, break into a near powder-like consistency, and/or not have a fresh plant-like smell. In some cases, a person may fold marijuana into an envelope or piece of paper that may have a date.

A judgment of the age of paraphernalia can be difficult. A bong or pipe that is well used will be darkened from the burn residue of the marijuana. In cases where the marijuana use just occurred, the bong or pipe may be hot or warm. When marijuana smokers make a “blunt,”they will discard the tobacco contents, which may then be found in the garbage or bits may be discovered on the floor. Regarding marijuana edibles, light-colored baked goods like chocolate chip cookies may have a green hue. Edibles may have a noticeable odor, especially if they have high marijuana content.
<h2>Additional Signs</h2>
[media image="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/07/Driving-under-the-influence-of-marijuana.jpg" alt="Driving under the influence of marijuana"][/media]

Individuals who are concerned that someone they care about is abusing marijuana should be advised that this drug invites <a href="http://www.ccsa.ca/Resource%20Library/CCSA-Cannabis-use-Risky-behaviours-and-Harms-2014-en.pdf" target="_blank" rel="noopener">risky behavior</a>.

Uncharacteristically risky or reckless behavior may be a sign that marijuana use or other drug use is occurring. Some of the risky behaviors associated with marijuana include:
<ul>
 	<li>Driving under the influence of marijuana</li>
 	<li>Being a passenger while knowing the driver is "high"</li>
 	<li>Having unprotected sex</li>
 	<li>Conflicts, public fights, or relationship problems</li>
 	<li>Legal troubles such as a DUI arrest</li>
</ul>
[quote]When marijuana users continue to use this drug despite negative outcomes or acute problems, they may be in the grip of addiction.[/quote]

As marijuana is addictive, it has the potential to become a priority in a person's life. As marijuana use becomes a pressing priority, important obligations will likely begin to suffer. Often, concerned individuals will become especially motivated to help the marijuana abuser to get help after an incident, such as a DUI, or other clear indication of a problem. <a href="/marijuana-rehab/">It is never too soon to seek treatment.</a>

What Are the Signs That Someone Is High?

[callout title="What Are The Long-Term Effects of Heavy Adderall Use?"]

People who abuse a great deal of Adderall over a long period of time may experience:

[columns count="2"]
<ul>
 	<li>Sleep difficulties</li>
 	<li>Inability to concentrate</li>
 	<li>Lack of motivation</li>
 	<li>Depression</li>
 	<li>Irritability</li>
 	<li>Lethargy</li>
 	<li>Fatigue</li>
 	<li>Aggression</li>
 	<li>Thoughts of suicide</li>
 	<li>Mood swings</li>
 	<li>Paranoia</li>
 	<li>Hallucinations</li>
 	<li>Anxiety</li>
 	<li>Panic attacks</li>
 	<li>Heart disease</li>
 	<li>Weight loss</li>
 	<li>Headaches</li>
 	<li>Tremors</li>
 	<li>Constipation</li>
</ul>
[/columns]

[/callout]
<p align="right"><a href="https://americanaddictioncenters.org/adderall/long-term-effects/esp" rel="alternate" hreflang="es">Spanish Version</a></p>
[quote]Close to 50 million prescription stimulant drugs like Adderall were dispensed in 2011 to treat symptoms of attention deficit hyperactivity disorder, or ADHD.[/quote]

<img class="alignright wp-image-28243" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/adderall-abuse.jpg" alt="adderall abuse" width="246" height="211" />

This represents an almost 40 percent rise in these prescriptions since 2007, the <a href="http://www.deadiversion.usdoj.gov/nflis/spec_rpt_adhd_2012.pdf" target="_blank" rel="noopener">Drug Enforcement Agency</a> (DEA) states.ADHD is one of the most common childhood neurobiological disorders. The <a href="http://www.cdc.gov/nchs/fastats/adhd.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a> (CDC) reported that as of July 2015, almost 10 percent, or close to 6 million, American children between the ages of 4 and 17 had been diagnosed with ADHD at some point in their lifetimes.

Adderall (amphetamine-dextroamphetamine) is intended to increase focus and attention spans in those suffering from ADHD. It is also prescribed to treat narcolepsy at times.

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<img class="alignleft wp-image-28255" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/adderall-abuse-rates-college.jpg" alt="adderall abuse rates college" width="335" height="287" />

As prescriptions for Adderall rise, so may its potential for diversion and nonmedical use, which increases its health risks too. Adderall is abused as a <a href="https://americanaddictioncenters.org/adderall/adderall-abuse-among-college-students">"smart drug" across college campuses</a>. It may be abused by students to combat pressures of higher education, as students perceive it will help them get better grades because they can stay up and study for longer.

A study at the University of Kentucky found that 30 percent of its students had abused an ADHD stimulant drug like Adderall at some point as a possible "study enhancer," <a href="http://www.cnn.com/2011/09/01/health/drugs-adderall-concentration/" target="_blank" rel="noopener"><em>CNN</em></a> reports.

Adderall also suppresses the appetite and may also be abused as a weight loss drug. Other times it may be used in conjunction with other drugs or alcohol recreationally, or to get "high." Mixing Adderall with other substances can be very dangerous and may more easily result in a life-threatening overdose or negative interaction between the substances.

[quote]Stimulant drugs like Adderall are addictive and using them recreationally may increase the chances of developing a psychological and physical dependence on them.[/quote]

Adderall's side effects include: physical damage to the brain, internal systems, and organs.
<h2>How Extended Adderall Use Affects the Brain</h2>
Stimulants increase concentration and energy levels while decreasing the need for sleep and suppressing the appetite. Adderall increases the activity of several neurotransmitters, such as serotonin, norepinephrine, and especially dopamine. Over time, the changes in dopamine activity can impact our brain’s reward center, and alter our ability to experience pleasure without the chemical support of continued amphetamine use.. The more often Adderall is taken, the more ingrained these changes become. A tolerance to the drug may form, and more Adderall may be needed at each dose in order to feel the same desired effects.

As Adderall leaves the bloodstream, withdrawal symptoms and drug cravings may occur, indicating a physical and emotional dependence on the drug. The way in which Adderall is abused, along with the amount and duration of abuse can affect the dependence level to the drug. Crushing the pills and then injecting or snorting them, for example, sends the drug into the brain more rapidly than ingesting them whole and having them enter the bloodstream via the digestive tract. As a result, injecting or snorting the crushed pills increases the chances for a life-threatening overdose and the potential for addiction. Addiction is a disease that affects each person individually, and environmental and biological factors may also play a role in its onset.

Someone who is dependent on Adderall may have trouble sleeping and concentrating, notice a lack of motivation, and feel depressed, irritable, lethargic, or fatigued when it is removed from the body. <a href="https://americanaddictioncenters.org/amphetamine">Abusing amphetamines</a> like Adderall may raise the risk of aggression and suicidal thoughts, according to <em><a href="https://abcnews.go.com/Health/MindMoodNews/adderall-psychosis-suicide-college-students-abuse-study-drug/story?id=12066619&amp;page=2" target="_blank" rel="noopener">ABC News</a></em>. For someone who has been abusing Adderall for an extended period of time, the emotional aspect of withdrawal may be the most noticeable side effect. Natural production of dopamine is reduced, causing low moods and trouble feeling pleasure without the drug.

[quote] The more and longer Adderall is abused, the more pronounced the mood swings may be when it is no longer available in the body. Most of these changes in the brain will likely be repaired over time with sustained abstinence and proper care and support, fortunately.[/quote]

In some cases, Adderall and other prescription stimulants have been reported to cause psychosis and schizophrenia-like symptoms, such as paranoid delusions, hallucinations, and other behavioral or mood disturbances, according to the journal <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/" target="_blank" rel="noopener"><em>Molecular Psychiatry</em></a>. Anxiety and panic attacks may also be triggered by long-term use of an amphetamine stimulant or during Adderall withdrawal. The <em><a href="http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf" target="_blank" rel="noopener">U.S. Food and Drug Administration</a></em>, or FDA, even prints warnings on Adderall labels about potential negative psychiatric side effects. Symptoms may be heightened in someone with a history of mental illness or an underlying mental health disorder, such as bipolar disorder or schizophrenia.

[link-bank title="More on Long-Term Effects"]
<ul>
 	<li><a href="/health-complications-addiction/permanent-effects/">Permanent Effects of Drug Abuse</a></li>
 	<li><a href="/marijuana-rehab/long-term-effects/">Marijuana</a></li>
 	<li><a href="/methadone-addiction/side-effects/">Methadone </a></li>
 	<li><a href="/pcp-abuse/long-term-effects/">PCP</a></li>
 	<li><a href="/phenobarbital-abuse/long-term-side-effects/">Phenobarbital</a></li>
 	<li><a href="/valium-treatment/long-term/">Valium</a></li>
 	<li><a href="/vyvanse-abuse/risks-long-term-damage/">Vyvanse</a></li>
 	<li><a href="/xanax-treatment/long-term-severe/">Xanax</a></li>
</ul>
[/link-bank]
<h2>Physical Side Effects</h2>
<img class="alignright size-full wp-image-38976" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/side-effects-of-adderall-use.jpg" alt="Adderall side effects" width="375" height="300" />

Stimulants like Adderall raise body temperature, heart rate, and blood pressure, and repeated use or abuse, particularly in high doses, can create a range of medical issues from a stroke to a seizure to a heart attack.

Adderall can cause damage to the heart and cardiovascular system when used for a prolonged period of time, especially when used in excess. The most common ADHD medication cardiovascular problems reported are hypertension (high blood pressure) and tachycardia (irregular heart rate), as published by <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/" target="_blank" rel="noopener"><em>Brain and Body</em></a>. Sudden cardiac death may also be a potential side effect of Adderall.

[callout title="Other side effects of abusing Adderall long-term include:"]
<ul>
 	<li>Heart disease</li>
 	<li>Dizziness</li>
 	<li>Abdominal pain</li>
 	<li>Weight loss</li>
 	<li>Insomnia</li>
 	<li>Dry mouth</li>
 	<li>Heart palpitations</li>
 	<li>Headaches</li>
 	<li>Tremors</li>
 	<li>Trouble breathing</li>
 	<li>Constipation</li>
 	<li>Hyperactivity</li>
 	<li>Feeling jittery or "on edge"</li>
</ul>
[/callout]

[quote]Using Adderall heavily for a long period of time increases all the risk factors and potential long-term side effects, which may get progressively worse.[/quote]

The heart muscle may be weakened with prolonged stimulant abuse, leading to more complications. Changes in the brain, as well as mood and behavior issues related to prolonged Adderall abuse, may also continue unless the drug is safely removed from the body.

Detox from Adderall is not sufficient treatment, however. It must be followed with a substance abuse treatment program to help prevent relapse and support long-term recovery.
<h3 class="text-center">Featured Content</h3>
<a href="https://americanaddictioncenters.org/co-occurring-disorders/"><img class="aligncenter size-full wp-image-28181" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/01/co-occurring-disorders-further-reading.png" alt="co-occurring-disorders-further-reading" width="350" height="300" /></a>
<a href="https://americanaddictioncenters.org/rehab-guide/#financial-guide"><img class="aligncenter size-full wp-image-28180" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/01/finance-guides-further-reading.png" alt="finance-guide-further-reading" width="350" height="300" /></a>
<a href="https://americanaddictioncenters.org/health-complications-addiction/"><img class="aligncenter size-full wp-image-28178" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/01/health-risks-further-reading.png" alt="health-risks-further-reading" width="350" height="300" /></a>
<a href="https://americanaddictioncenters.org/treating-depression-substance-abuse/"><img class="aligncenter size-full wp-image-28179" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/01/depression-treatment-further-reading.png" alt="depression-treatment-further-reading" width="350" height="300" /></a>

Long-Term Effects of Adderall Use

Drug and Alcohol Withdrawal Symptoms, Timelines, and Treatment

[callout]
<h2>Alcohol Withdrawal Timeline</h2>
Alcohol withdrawal side effects and symptoms can be broken down into three stages:
<ul>
 	<li>Stage 1: Anxiety, <a href="https://americanaddictioncenters.org/alcoholism-treatment/insomnia/" target="_blank" rel="noopener">insomnia</a>, nausea, and abdominal pain characterize this stage, which begins 8 hours after the last drink.</li>
 	<li>Stage 2: High blood pressure, increased body temperature, unusual heart rate, and confusion come with this stage, which begins 24-72 hours after the last drink.</li>
 	<li>Stage 3: Hallucinations, fever, seizures, and agitation come with this stage, which tends to begin 2-4 days after the last drink.</li>
</ul>
All symptoms tend to decrease within 5-7 days.
[/callout]

Unlike many other addictive substances, alcohol is legal to those over age 21 and readily available. Many people drink alcohol on a regular basis without any issues. In fact, <a href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551" target="_blank" rel="noopener">Mayo Clinic</a> publishes that drinking in moderation (no more than one drink a day for a woman and two for a man) may even have some health benefits. Patterns of binge or heavy drinking, (drinking more than four drinks for a woman or five for a man in a span of two hours, or more than seven drinks a week for a woman and 14 per week for a man) can contribute to a problem with alcohol, according to <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking" target="_blank" rel="noopener">NIAAA</a>.

Almost all American adults over the age of 18 have consumed alcohol at some point. The <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a> (NIAAA) estimates close to 87 percent of the adult population has had at least one drink in their lifetime.

Stats on alcohol abuse and its effects include:
<ul>
 	<li>An estimated 16.6 million American adults in 2013 had an alcohol use disorder (AUD), according to the <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics" target="_blank" rel="noopener">NIAAA</a>.</li>
 	<li>One out of every three visits to the emergency room is related to the consumption of alcohol, per the <a href="http://www.ibtimes.com/1-out-3-er-visits-are-alcohol-related-heres-what-patients-drank-charts-1395699" target="_blank" rel="noopener"><em>International Business Times</em></a>.</li>
 	<li>Alcohol consumed in excess was responsible for one out of every 10 deaths in working age adults (ages 20-64) from 2006-2010, the <a href="http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a>(CDC) publishes.</li>
 	<li>Alcohol is the third-leading preventable cause of death in America according to NIAAA, as 88,000 people each year die from an alcohol-related cause.</li>
</ul>
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&nbsp;

<img class="aligncenter size-full wp-image-30897" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/alcohol-withdrawal.png" alt="alcohol abuse withdrawal" width="700" height="400" />

As someone drinks, levels of dopamine are elevated in the brain, resulting in a flood of pleasant feelings. Alcohol can elevate mood, increase self-confidence, and lower inhibitions. As alcohol leaves the bloodstream, these feelings and dissipate.

[quote]Repetitive alteration of the dopamine levels in the brain can cause it to expect the presence of alcohol and therefore discontinue its production at previous levels without the substance.[/quote]

<img class="aligncenter size-full wp-image-27120" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/er_alcohol.jpg" alt="er and alcohol" width="400" height="365" />

The more a person drinks, the more tolerant to alcohol the body becomes and the more dependent the brain may be on its interference. When alcohol's effects wear off, someone who is dependent on it may suffer from withdrawal symptoms that can range from mild to life-threatening.

<iframe src="https://www.youtube.com/embed/mguKKuOfvhM" width="100%" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

[callout title="
<h2>Alcohol Withdrawal Side Effects</h2>
"]
Alcohol withdrawal is likely to start between six hours and a day after the last drink, as reported in <a href="http://www.aafp.org/afp/2013/1101/p589.html" target="_blank" rel="noopener"><em>American Family Physician</em></a>. Withdrawal can be broken down into three stages of severity:
<ul>
 	<li><em>Stage 1 (mild): </em>anxiety, insomnia, nausea, abdominal pain and/or vomiting, loss of appetite, fatigue, tremors, depression, foggy thinking, mood swings, and heart palpitations</li>
 	<li><em>Stage 2 (moderate): </em>increased blood pressure, body temperature and respiration, irregular heart rate, mental confusion, sweating, irritability, and heightened mood disturbances</li>
 	<li><em>Stage 3 (severe/delirium tremens): </em>hallucinations, fever, seizures, severe confusion, and agitation</li>
</ul>
[/callout]

Alcohol withdrawal is highly variable, and it is influenced by several factors, such as length of time drinking, the amount consumed each time, medical history, presence of a co-occurring mental health disorder, family history of addiction, childhood trauma, and stress levels. The use of other drugs in conjunction with alcohol can also influence withdrawal and increase the potential dangers and side effects. The more dependent on alcohol a person is, the more likely the person is to experience more severe withdrawal symptoms. Each person may not go through every stage of withdrawal, therefore.

[quote]The most serious form of alcohol withdrawal is <a href="https://americanaddictioncenters.org/alcoholism-treatment/delirium-tremens-symptoms-and-treatment/">delirium tremens (DTs)</a>, which occurs in 3-5 percent of individuals in alcohol withdrawal, according to the <a href="http://www.nejm.org/doi/full/10.1056/NEJMra1407298" target="_blank" rel="noopener"><em>New England Journal of Medicine</em></a> (NEJM), and it can be fatal without treatment.[/quote]

DTs may not start for a day or two after alcohol leaves the bloodstream, and it can occur without warning. It is primarily for this reason that alcohol withdrawal should be closely supervised by a medical professional who can continually monitor vital symptoms and ensure the individual's safety during detox. Stopping drinking “cold turkey”is never recommended without medical supervision. Alcohol withdrawal can be fatal, as the brain and central nervous system experience a rebound after being suppressed by alcohol repetitively for an extended period of time. Sudden removal of the central nervous system depressant can be life-threatening.

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<h2>Alcohol Detox Timeline</h2>
There is no specific and concrete timeline for alcohol withdrawal; however, it is typically held that withdrawal will follow the following general timeline, as detailed by the <a href="https://www.nlm.nih.gov/medlineplus/ency/article/000764.htm" target="_blank" rel="noopener">National Library of Medicine</a> (NLM):
<ul>
 	<li><em>Roughly 8 hours after first drink:</em> The first stage withdrawal symptoms may begin.</li>
 	<li><em>After 24-72 hours</em>: Symptoms generally peak in this time period, and stage 2 and 3 symptoms can rapidly manifest.</li>
 	<li><em>5-7 days later</em>: Symptoms may start to taper off and decrease in intensity.</li>
 	<li><em>Beyond the first week:</em> Some side effects, particularly the psychological ones, may continue forseveral weekswithout treatment.</li>
</ul>
<img class="aligncenter size-full wp-image-27185" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/alcohol_detox_timeline.jpg" alt="alcohol detox timeline" width="730" height="193" />

During detox, the first step is usually to monitor and control the physical symptoms and reach a stable point. <a href="https://americanaddictioncenters.org/medical-detox-centers">This is often accomplished via medical detox</a>, which may use medications to treat symptoms like nausea, dehydration, seizures, and insomnia. Benzodiazepines are commonly used during alcohol detox to reduce some of the potential over-activity the central nervous system may undergo as it attempts to restore its natural order. Blood pressure, heart rate, respiration, and body temperature should all be closely monitored in a medical detox center, and steps can be taken to ensure that they remain at safe levels.

<img class="alignleft size-full wp-image-27180" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/healthy_diet.jpg" alt="healthy diet" width="301" height="333" />

At times, alcohol usage may be slowly reduced over a period of time through a detailed tapering schedule that should be set up and supervised by a medical professional. In this way, alcohol can be weaned out of the system in a controlled manner in order to avoid more dangerous withdrawal side effects. Someone dependent on alcohol may also suffer from malnutrition. Supplements and the implementation of a healthy diet and regular sleep schedule may improve withdrawal side effects and help the body heal faster.
<h2>Managing Symptoms in a Detox Center</h2>
After the physical symptoms have been controlled, mental health professionals can help reduce some of the more powerful emotional side effects of withdrawal.

Anxiety, depression, and potential suicidal ideation can be managed by medications coupled with therapy and counseling sessions. Preventing relapse is an important part of any alcohol detox center, and 12-step groups and individual therapy can offer continued support through detox and beyond. Alcohol detox centers use three medications, which are approved by the <a href="http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction" target="_blank" rel="noopener"> U.S. Food and Drug Administration</a> (FDA), to help with alcohol-related cravings in the treatment of alcohol withdrawal and dependency: disulfiram, naltrexone, and acamprosate. These medications work to manage withdrawal symptoms and discourage individuals from drinking again. Naltrexone blocks opioid receptors in the brain, thereby reducing cravings and the potential rewards that may come from drinking, while acamprosate is believed to work on long-term withdrawal symptoms. Disulfiram can make people sick if they drink, thereby making drinking undesirable. A fourth medication, topiramate, also shows promise for the treatment of alcohol use disorders by also potentially interfering with the way alcohol "rewards" drinkers, as reported in the journal <a href="http://www.ascpjournal.org/content/8/1/12" target="_blank" rel="noopener"><em>Addiction Science and Clinical Practice</em></a>. Alcohol withdrawal should not be attempted without theprofessional help of a detox center, as symptoms can pop up and magnify very quickly. Even after the physical effects of alcohol withdrawal are under control, protracted withdrawal, or the continuation of emotional symptoms and cravings, can continue and may lead to relapse without the right level of support and treatment.

[quote]A medical detox program can provide the most comprehensive and supportive environment during all stages of alcohol withdrawal and detox.[/quote]
<p data-pm-slice="1 1 []">[/button-styled]</p>
<p data-pm-slice="1 1 []">[button-styled link="/insurance-coverage" width='auto']Outcomes Study[/button-styled]</p>

Alcohol Withdrawal Symptoms, Treatment, and Timeline

Clonazepam Withdrawal Symptoms, Length, and Treatment

[content-overview]
Opiate drugs, including prescription opioid painkillers and heroin, can produce withdrawal symptoms just hours after the last dose, and the symptoms can last for a week or more. Unassisted withdrawal may not be life-threatening, but it can lead to relapse. Medications and therapy, accessed in medical detox, may make relapse less likely.

Withdrawal symptoms include:
<ul>
 	<li>Nausea</li>
 	<li>Muscle cramping</li>
 	<li>Depression</li>
 	<li>Agitation</li>
 	<li>Anxiety</li>
 	<li>Opiate cravings</li>
</ul>
[/content-overview]

[quote]The <a href="http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse" target="_blank" rel="noopener">National Institute on Drug Abuse</a> (NIDA) publishes that between 26.4 million and 36 million people around the globe abuse opiate drugs, which includes prescription pain relievers and the illegal drug heroin.[/quote]

<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/OpiateWithdrawalTimeline.jpg"><img class="aligncenter size-full wp-image-56645" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/OpiateWithdrawalTimeline.jpg" alt="timeline, symptoms and treatment for opioid withdrawal" width="700" height="3159" /></a>

Opiates change the way the brain responds to pain stimuli and can also produce a "high" feeling by disrupting the reward and pleasure centers in the brain.

The central nervous system, which includes the brain, cardiovascular and respiratory systems,
has opioid receptors that receive opiate drugs, and these drugs bring a variety of physical and emotional effects. Heart
rate, respiration, blood pressure, and body temperature are lowered while pleasant feelings are increased.

[callout]
Repeated use or abuse of an opioid drug can actually change the way an individual's brain chemistry works and lead to physical and psychological dependence. The body may not feel "normal" anymore without the drug's interaction, and <a href="/withdrawal-timelines-treatments/oxycodone/">withdrawal symptoms may start in between doses or when an individual stops taking the opiate.</a>Each opiate drug has a unique half-life, which is the length of time it takes for half the amount of a drug to be eliminated from the body. As a result, withdrawal symptoms may start at different times, depending on the drug and method in which it is taken.Heroin is the fastest acting opioid; therefore, it also has the shortest half-life, according to the Drug Enforcement Administration (DEA). Its half-life may only be a matter of minutes to a few hours. Short-acting prescription opioid drugs, such as immediate-release oxycodone (OxyContin) and hydrocodone (Vicodin), have half-lives around 4-6 hours, the <a href="http://americanpainsociety.org/uploads/education/section_3.pdf" target="_blank" rel="noopener">American Pain Society</a> publishes. The <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/017116s029lbl.pdf" target="_blank" rel="noopener">U.S. Food and Drug Administration</a> (FDA) reports that the <a href="/methadone-addiction/how-long-in-system/">half-life of methadone may be much longer</a>, closer to an average of 30 hours.
[/callout]

Injecting, snorting, and smoking drugs may have a more immediate effect; however, they may also stop working sooner than drugs that are swallowed and digested through the stomach and digestive system. The start of withdrawal is highly dependent on the type and method of opioid drug abused.

[button-color link='insurance-coverage']Learn more about insurance coverage and verify your insurance with AAC[/button-color]
<h2>Signs of Opiate Withdrawal</h2>
Opiate withdrawal symptoms may range from mild to severe, depending on how dependent the individual is on an opioid drug. Dependency can be tied to the length of time taking a particular drug, dosage amount, which drug was taken, how the drug was taken, underlying medical conditions, the co-occurring presence of a mental health issue, and certain biological and environmental factors, such as family history of addiction, previous trauma, or highly stressful and unsupportive surroundings. Withdrawal from an opioid drug may roughly adhere to the following timeline, although it can vary from person to person.
<h3>Early Withdrawal Symptoms</h3>
These usually start within 6-12 hours for short-acting opiates, and they start within 30 hours for longer-acting ones:
<ul>
 	<li>Tearing up</li>
 	<li>Muscle aches</li>
 	<li>Agitation</li>
 	<li>Trouble falling and staying asleep</li>
 	<li>Excessive yawning</li>
 	<li>Anxiety</li>
 	<li>Nose running</li>
 	<li>Sweats</li>
 	<li>Racing heart</li>
 	<li>Hypertension</li>
 	<li>Fever</li>
</ul>
<h3>Late Withdrawal Symptoms</h3>
These peak within 72 hours and usually last a week or so:
<ul>
 	<li>Nausea and vomiting</li>
 	<li>Diarrhea</li>
 	<li>Goosebumps</li>
 	<li>Stomach cramps</li>
 	<li>Depression</li>
 	<li>Drug cravings</li>
</ul>
Some of the psychological withdrawal symptoms and cravings for opioid drugs may continue longer than a week in some cases. Therapy and psychological support provided by a mental health professional as a part of a complete substance abuse treatment program can decrease the symptoms and side effects of withdrawal.

[callout title="More on Withdrawal &amp; Timelines"]
<ul>
 	<li><a href="/dilaudid-abuse/how-long-is-withdrawal">Hydromorphone (Dilaudid)</a></li>
 	<li><a href="/heroin-treatment/withdrawal-symptoms">Heroin</a></li>
 	<li><a href="/methadone-addiction/as-short-term-detox">Methadone</a></li>
 	<li><a href="/morphine-treatment/timelines-symptoms">Morphine</a></li>
 	<li><a href="/opana-treatment/detox-timeline">Opana</a></li>
 	<li><a href="/suboxone/withdrawal">Suboxone</a></li>
 	<li><a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/codeine">Codeine</a></li>
 	<li><a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/vicodin">Hydrocodone (Vicodin)</a></li>
 	<li><a href="https://americanaddictioncenters.org/demerol-abuse">Meperidine (Demerol)</a></li>
 	<li><a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/oxycodone">Oxycodone (Percocet or Oxycontin)</a></li>
</ul>
[/callout]
<h2>Detox Options</h2>
There are several treatment and detox options for the removal of opioids from the body, and some may provide a more comprehensive model than others. Medical detox, for instance, encompasses both pharmacological and psychological treatment methodologies while under close supervision of both medical and mental health specialists in a safe and comforting residential setting, while standard detox may be performed in an outpatient basis. Opiate withdrawal symptoms can be very uncomfortable, and medical detox may provide the safest and smoothest way to detox. Vital signs, such as blood pressure, respiration levels, body temperature, and heart rate, can all be closely monitored in a medical detox center that may utilize medications to regulate brain and body functions.Mental health professionals can also evaluate and stabilize individuals during medical detox. While there is no specific timeline for detox, as each individual will likely experience withdrawal from opiates differently, medical detox usually lasts 5-7 days.

[quote]Opioid drugs should not be stopped suddenly, without physical and emotional support and supervision, as the side effects of withdrawal may be powerful and even have dangerous complications.[/quote]

Medications, such as anticonvulsants, antidepressants, and other symptom-specific pharmaceuticals, may be useful during medical detox to control the more difficult withdrawal symptoms.

Medical professionals may help an individual wean off opioid drugs by slowly lowering, or tapering, the dosage during medical detox. This keeps the opioid receptors filled and prevents the onset of severe withdrawal symptoms. Drug cravings and withdrawal as a whole may be managed by replacing a short-acting opioid like heroin with a longer-acting one such as methadone. Buprenorphine is a partial opioid agonist often used during opioid detox and dependency treatment as well, as it remains active in the body for longer than most opioids and requires a lower dosage. Partial agonists also do not usually create the same "high" as full agonists do, therefore making them less likely to be abused. Buprenorphine even stops being effective after a certain point, further acting as an abuse deterrent.
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Naloxone and naltrexone are opioid antagonists that bind to opioid receptor sites along the central nervous system and "block" other opioids from filling them. This means that even if someone tries to take a drug like heroin while on an antagonist, the drug will not produce the desired effects and instead may cause a precipitated withdrawal syndrome to start. Precipitated withdrawal is the sudden and rapid onset of withdrawal symptoms, which can be intense and can serve to keep someone on an antagonist from attempting to abuse an opioid agonist at the same time.

Naloxone is added to buprenorphine as an inactive relapse-prevention agent in drugs like Suboxone and Zubsolv unless the drugs are altered and then abused via injection. Naltrexone products like Vivitrol are used more commonly to help prevent relapse after detox is completed and opioid drugs are fully removed from the brain and body. The intention of detox is to stabilize an individual dependent on opioids both emotionally and physically, and detox may use both pharmacological and psychological therapy methods to accomplish this.
<h2>Medical Detox as Part of a Whole Treatment Plan</h2>
Since addiction is a chronic and relapsing disease, with both physical and emotional side effects and symptoms, treatment needs to be comprehensive. Medical detox is relatively short and can provide the stepping stones for a more stable recovery. Relapse is common for individuals struggling with addiction as it may seem like a return to drug abuse may offer relief. After a period of not using drugs, tolerance to certain levels of drugs may be reduced, however, and relapse after detox can be especially dangerous as it may increase the risk for a fatal overdose.

Drug overdose is the leading cause of injury death in America. The <a href="http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf" target="_blank" rel="noopener">American Society of Addiction Medicine</a> (ASAM) estimates that 100 Americans die of a drug overdose every day, and 46 people in the United States die daily due to prescription opioid overdose. <a href="http://www.nytimes.com/2014/12/23/upshot/painkiller-abuse-a-cyclical-challenge.html?_r=0" target="_blank" rel="noopener"><em>The New York Times</em></a> reports that opioids are responsible for more deaths than any other medication or drug. Medical detox may help smooth out withdrawal, reducing side effects, preventing serious complications, and reducing drug cravings. This can provide a good start toward recovery and help to maintain sobriety long-term.

[quote]Detox followed with counseling, education, family and individual therapy, and support groups can help an individual stop using drugs and maintain sobriety.[/quote]
<h4>About Drug and Alcohol Detox</h4>
<ul>
 	<li><a href="/drug-detox/same-day-admittance">Same Day Admittance</a></li>
 	<li><a href="/drug-detox/cost">What Is the Cost?</a></li>
</ul>

Amanda Lautieri, B.A.

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