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Encyclopedia > Withdrawal

Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. The term can also, less formally, refer to symptoms that appear after discontinuing a drug or other substance (unable to cause true physical dependence) that one has become psychologically dependent upon. Physical dependence describes increased tolerance of a drug combined with a physical need of the drug to function. ... Addiction is a chronic or recurrent condition proposed to be precipitated by one or more of the following: genetic, biological/pharmacological and social factors. ...

Contents

Overview

The sustained use of many kinds of drugs causes reversible adaptations within the body that tend to lessen the drug's original effects over time, a phenomenon known as drug tolerance. To have these adaptations to a drug is to have a physical dependency on it, for when the drug is suddenly discontinued or decreased, the adaptations do not immediately disappear. Unopposed by the drug, the adaptations appear as withdrawal signs and symptoms that are generally the opposite of the drug's direct effects. Depending primarily on the drug's elimination half-life, withdrawal symptoms can appear within a few hours to several days after discontinuation. Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ... Addiction is a compulsion to repeat a behaviour regardless of its consequences. ... The elimination half-life of a drug (or any xenobiotic agent) refers to the timecourse necessary for the quantity of the xenobiotic agent in the body (or plasma concentration) to be reduced to half of its original level through various elimination processes. ...


The withdrawal symptoms associated with many recreational drugs are well-known. However, many drugs that do not generally cause euphoria, and are therefore not generally abused or thought of as addictive, also induce physical dependence with associated withdrawal. Examples include beta blockers, corticosteroids such as cortisone, many anticonvulsants and most antidepressants. Nevertheless, sudden withdrawal from these medications can be harmful or even fatal; this is why many prescription labels explicitly warn the patient not to discontinue the drug without doctor approval. Recreational drug use is the use of psychoactive drugs for recreational purposes rather than for work, medical or spiritual purposes, although the distinction is not always clear. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... An antidepressant is a medication used primarily in the treatment of clinical depression. ...


Withdrawal from drugs of abuse

Central to the role of nearly all drugs that are commonly abused to produce euphoria is the nucleus accumbens, the brain's "pleasure center". Neurons in the nucleus accumbens use the neurotransmitter dopamine, so while specific mechanisms vary, nearly every drug of abuse either stimulates dopamine release or enhances its activity, directly or indirectly. Sustained use of the drug results in less and less stimulation of the nucleus accumbens until eventually it produces no euphoria at all. Discontinuation of the drug then produces a withdrawal syndrome characterized by dysphoria — the opposite of euphoria — as nucleus accumbens activity declines below normal levels. Look up euphoria in Wiktionary, the free dictionary. ... The nucleus accumbens (NAcc), also known as the accumbens nucleus or as the nucleus accumbens septi (Latin for nucleus leaning against the septum), is a collection of neurons located where the head of the caudate and the anterior portion of the putamen meet just lateral to the septum pellucidum. ... Dopamine is a chemical naturally produced in the body. ... Look up dysphoria in Wiktionary, the free dictionary. ...


Withdrawal symptoms can vary significantly among individuals, but there are some commonalities. Subnormal activity in the nucleus accumbens is often characterized by depression, anxiety and craving, and if extreme can help drive the individual to continue the drug despite significant harm — the definition of addiction — or even to suicide. Grieving Thai females. ... This article includes a list of works cited but its sources remain unclear because it lacks in-text citations. ... Addiction is a chronic or recurrent condition proposed to be precipitated by one or more of the following: genetic, biological/pharmacological and social factors. ...


However, addiction is to be carefully distinguished from physical dependence. Addiction is a psychological compulsion to use a drug despite harm that often persists long after all physical withdrawal symptoms have abated. On the other hand, the mere presence of even profound physical dependence does not necessarily denote addiction, e.g., in a patient using large doses of opioids to control chronic pain under medical supervision.


As the symptoms vary, some people are, for example, able to quit smoking "cold turkey" (i.e., immediately, without any tapering off) while others may never find success despite repeated efforts. However, the length and the degree of an addiction can be indicative of the severity of withdrawal. For other uses of Cold turkey, see Cold turkey (disambiguation). ... Addiction is a chronic or recurrent condition proposed to be precipitated by one or more of the following: genetic, biological/pharmacological and social factors. ...


Withdrawal is a more serious medical issue for some substances than for others. While nicotine withdrawal, for instance, is usually managed without medical intervention, attempting to give up a benzodiazepine or alcohol dependency can result in seizures and worse if not carried out properly. An instantaneous full stop to a long, constant alcohol use can lead to delirium tremens, which may be fatal. Not to be confused with Niacin, which is the oxide of Nicotine, and has a very different biological effect. ... Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. ... Bottles of cachaça, a Brazilian alcoholic beverage. ... A chemical dependency is such a strong dependency on a substance that it becomes necessary to have this substance just to function properly; The need of a substance developed from abusing the substance, requiring the substance for survival, like the need for food, or water See also: addiction drug tolerance... This article is about the medical condition. ... For the beer, see Delirium Tremens (beer). ...


An interesting side-note is that while physical dependence (and withdrawal on discontinuation) is virtually inevitable with the sustained use of certain classes of drugs, notably the opioids, psychological addiction is much less common. Most chronic pain patients, as mentioned earlier, are one example. There are also documented cases of soldiers who used heroin recreationally in Vietnam during the war, but who gave it up when they returned home (see Rat Park for experiments on rats showing the same results). It is thought that the severity or otherwise of withdrawal is related to the person's preconceptions about withdrawal. In other words, people can prepare to withdraw by developing a rational set of beliefs about what they are likely to experience. Self-help materials are available for this purpose. Heroin ((INN) Diacetylmorphine , (BAN) diamorphine) is a semi-synthetic opioid. ... Dr. Bruce K. Alexander Rat Park was a study into drug addiction conducted in the 1970s by American psychologist Bruce K. Alexander at Simon Fraser University in British Columbia, Canada. ... Though the term self-help can refer to any case whereby an individual or a group betters themselves economically, intellectually or emotionally, the connotations of the phrase have come to apply particularly to psychological or psychotherapeutic nostrums, often purveyed through the popular genre of the self-help book. ...


Withdrawal from prescription medicine

As mentioned earlier, many drugs should not be stopped abruptly[1] without the advice and supervision of a physician, especially if the medication induces dependence or if the condition they are being used to treat is potentially dangerous and likely to return once medication is stopped, such as diabetes, asthma, heart conditions and many psychological or neurological conditions, like epilepsy, hypertension, schizophrenia and psychosis. To be safe, consult a doctor before discontinuing any prescription medication. This article is about the disease that features high blood sugar. ... Cardiovascular disease refers to the class of diseases that involve the heart and/or blood vessels (arteries and veins). ... This article or section does not adequately cite its references or sources. ... Psychosis (not to be confused with psychopathy) is a generic psychiatric term for a mental state in which thought and perception are severely impaired. ...


Sudden cessation of the use of an antidepressant can deepen the feel of depression significantly (see "Rebound" below), and some specific antidepressants can cause a unique set of other symptoms as well when stopped abruptly. A recent form of antidepressant medication - Prozac Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, in the most common usage, is a medication taken to alleviate clinical depression or dysthymia (milder depression). ...


Discontinuation of selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed class of antidepressants, (and the related class serotonin-norepinephrine reuptake inhibitors or SNRIs) is associated with a particular syndrome of physical and psychological symptoms known as SSRI discontinuation syndrome. Effexor (venlafaxine) and Paxil (paroxetine), both of which have relatively short half-lives in the body, are the most likely of the antidepressants to cause withdrawals. Prozac (fluoxetine), on the other hand, is the least likely of SSRI and SNRI antidepressants to cause any withdrawal symptoms, due to its exceptionally long half-life. Serotonin Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders and some personality disorders. ... Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... SSRI discontinuation syndrome, also known as SSRI withdrawal syndrome or SSRI cessation syndrome, is a condition that can occur during or following the interruption or discontinuation of regular SSRI or SNRI antidepressant drug usage. ... Venlafaxine hydrochloride is a prescription antidepressant first introduced by Wyeth in 1993. ... Paroxetine or paroxetine hydrochloride is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... The elimination half-life of a drug (or any xenobiotic agent) refers to the timecourse necessary for the quantity of the xenobiotic agent in the body (or plasma concentration) to be reduced to half of its original level through various elimination processes. ... “Prozac” redirects here. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Serotonin norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ...


Rebound

Many substances can cause rebound effects (significant return of the original symptom in absence of the original cause) when discontinued, regardless of their tendency to cause other withdrawal symptoms. Rebound depression is common among users of any antidepressant who stop the drug abruptly, whose states are sometimes worse than the original before taking medication. This is somewhat similar (though generally less intense and more drawn out) than the 'crash' users of ecstasy, amphetamines, and other stimulants experience. Occasionally light users of opiates that would otherwise not experience much in the way of withdrawals will notice some rebound depression as well. Extended use of drugs that increase the amount of serotonin or other neurotransmitters in the brain can cause some receptors to 'turn off' temporarily or become desensitized, so, when the amount of the neurotransmitter available in the synapse returns to an otherwise normal state, there are fewer receptors to attach to, causing feelings of depression until the brain re-adjusts. Clinical depression (also called major depressive disorder, or sometimes unipolar when compared with bipolar disorder or sometimes called manic depression]) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... MDMA (3,4-methylenedioxy-N-methylamphetamine), most commonly known today by the street name ecstasy, (often abbreviated to E, X, or XTC ) is a semisynthetic entactogen of the phenethylamine family, whose primary effect is believed to be the stimulation of secretion—as well as inhibition of re-uptake—of large... Amphetamine is a synthetic drug originally developed (and still used) as an appetite suppressant. ... A stimulant is a drug which increases the activity of the sympathetic nervous system and produces a sense of euphoria or awakeness. ... An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ... Serotonin (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ... Neurotransmitters are chemicals that are used to relay, amplify and modulate electrical signals between a presynaptic and a postsynaptic neuron. ... In biochemistry, a receptor is a protein on the cell membrane or within the cytoplasm or cell nucleus that binds to a specific molecule (a ligand), such as a neurotransmitter, hormone, or other substance, and initiates the cellular response to the ligand. ... Illustration of the major elements in a prototypical synapse. ...


Other drugs that commonly cause rebound are:

With these drugs, the only way to relieve the rebound symptoms is to stop the medication causing them and weather the symptoms for a few days; if the original cause for the symptoms is no longer present, the rebound effects will go away on their own. A lot of damage can be picked up along the way when trying to come of something in the wrong way A decongestant is a broad class of drugs designed to symptomatically treat ailments affecting the respiratory system. ... Oxymetazoline is a topical decongestant used, in the form of Oxymetazoline hydrochloride, in products such as Vicks Sinex and Afrin. ... Xylometazoline (Neo-Rinoleina®; Novorin®; Olynth®; Otriven®; Otrivin®; Xymelin®) is a topical decongestant that is directly dosed into the nose, either as a spray or as drops. ... For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ... Ibuprofen (INN) (IPA: ) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Ipren or Ibumetin (Sweden), Ibuprom (Poland), Moment (Italy). ... A very old bottle of Aspirin Aspirin or acetylsalicylic acid is a drug in the family of salicylates, often used as an analgesic (against minor pains and aches), antipyretic (against fever), and anti-inflammatory. ... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ... Look up narcotic in Wiktionary, the free dictionary. ...


See also

A chemical dependency is such a strong dependency on a substance that it becomes necessary to have this substance just to function properly; The need of a substance developed from abusing the substance, requiring the substance for survival, like the need for food, or water See also: addiction drug tolerance... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ...

Literature

  1. ^ (2002) in Peter Lehmann: Coming off Psychiatric Drugs. Germany: Peter Lehmann Publishing. 1-891408-98-4. 

External links

  • Fact sheets, detox information and harm reduction strategies concerning illicit drugs

  Results from FactBites:
 
Withdrawal - Wikipedia, the free encyclopedia (765 words)
One of the primary agents in withdrawal is the brain chemical dopamine.
Withdrawal from addictive substances is typically followed by anxiety and craving, while behavioral withdrawal is marked by a need to continue the behavior despite reason or logic.
While nicotine withdrawal, for instance, is usually managed without medical intervention, attempting to give up a benzodiazepine or alcohol dependency can result in seizures and worse if not carried out properly.
Encyclopedia: Withdrawal (373 words)
Persons who require antidepressants, for instance, are not addicted to them in the technical sense, yet abrupt, unmonitored withdrawal from such medications can cause withdrawal symptoms that have been reported by many patients to be worse than those from opiates such as heroin or narcotic painkillers.
Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold sweats with goose bumps ("cold turkey"), kicking movements ("kicking the habit"), and other symptoms.
Sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal, although heroin withdrawal is considered much less dangerous than alcohol or barbiturate withdrawal.
  More results at FactBites »

 
 

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