What Are Acute Withdrawal Symptoms?

Abstinence reaction refers to the special psychological syndrome that occurs after stopping the use of drugs or reducing the dosage or using antagonists to occupy the receptor. The mechanism is due to the adaptive rebound caused by sudden withdrawal after long-term use. Withdrawal symptoms caused by drugs vary according to their pharmacological properties, and generally show symptoms that are opposite to the effects of the drugs used. For example, symptoms such as excitement, insomnia, and even seizures appear after alcohol withdrawal. Treatment should be slowly withdrawn from addictive drugs, prevent withdrawal syndrome, and treat symptomatically.

Basic Information

English name: abstinence reaction
Visiting department: Department of Psychological Medicine

Common causes: Sudden discontinuation after long-term medication causes adaptive rebound
Common symptoms: Symptoms contrary to the effect of the medication used, such as excitement, insomnia, and even seizures after alcohol withdrawal

Withdrawal etiology

Dependent drugs that can cause withdrawal syndrome are:

1. Benzodiazepines: ethanol, barbiturates and other hypnotics and sedatives.

2. Amphetamine: amphetamine, dexamphetamine, methamphetamine, prazomethoxol (Ritalin) and phenmorpholine.

3. Cannabis: Cannabis preparations, such as cannabis and marijuana.

4. Opioids: opiates, morphine, heroin, methadone, pethidine and so on.

5. Cocaine: Cocaine and coca leaves. 6. Hallucinogens: LSD, mescaline (Mercurine) and Pleurotus (Silospin).

7. Volatile compounds: acetone, carbon tetrachloride and other solvents, such as "olfactory glue".

8. Nicotine: tobacco, snuff.

Among the top eight drugs, opioid dependence is the most widespread and the most harmful. It not only causes great harm to the patient's body, but also causes many social problems, such as buying and selling, taking drugs, and crime.

Withdrawal Common Diseases

Opioid withdrawal syndrome

Symptoms occur 5 to 6 hours after discontinuation, manifesting as a strong craving for opioids, runny tears, muscle pain or cramps, gastrointestinal cramps, nausea, vomiting, diarrhea, dilated pupils, repeated chills, tachycardia, restless sleep Wait.

2. Benzodiazepine withdrawal syndrome

Symptoms appear 1 to 3 days after discontinuation of the medication, manifesting anxiety, tremor, nausea or vomiting, palpitation, headache, weakness, insomnia, and severe cases similar to tremor delirium or seizures. It usually lasts 3 days to 2 weeks.

3. Central stimulant withdrawal syndrome

Anxiety, depression, psychomotor retardation or agitation, gastrointestinal spasm, etc. also occur when amphetamine is discontinued. Suicide may occur in severe cases. Generally has a long history of use of psychoactive substances.

4. Conditions caused by smoking cessation (dependence on withdrawal syndrome)

Anxiety, chest tightness, cough, transient forgetfulness, lack of energy, weight gain, shaking, etc.

5. Vitamin B6 dependence syndrome

Convulsions, diarrhea, withdrawal reactions, convulsions, peripheral neuritis, glossitis, etc.

6. Hormone-dependent dermatitis

Photosensitivity, withdrawal response, glucosteroid dependence, skin redness, pimples, itching, etc.

7. Alcoholism mental disorders

Withdrawal response, alcoholic hallucinations, alcoholic tremor, alcohol dependence, alcoholism, jealousy, delusion, and alcoholic paranoia.

Withdrawal response test

Body surface symptoms

Runny nose, dilated pupils, erected body hair, sweating, mental palpitations, etc .;

2. Symptoms in the body

Abdominal pain, diarrhea, sore body, dizziness, headache, increased blood pressure, tachycardia, rapid pulse, fever, insomnia, anxiety, fear, nervousness, nightmares, etc .;

3. Violent dangerous tendencies

The patient begged or threatened medication in pain, pulling hair, bumping his head, rolling, self-harm, and even involuntary tremor, cramps in the limbs, dilated pupils, and severe blood pressure drop, collapse, and shock.

Differential diagnosis of withdrawal response

Drug dependence

Also known as drug addiction, refers to the mental and physical changes caused by the interaction between the body and drugs, and often has behaviors in order to experience the psychological effects of these drugs again, and sometimes to avoid the unpleasantness caused by drugs, and periodically 2. The characteristic of compulsive desire to use drugs continuously.

2. Withdrawal seizures

Also known as "rum attack" is a more common symptom during alcohol withdrawal (relative or absolute abstinence after chronic chronic alcoholism). More than 90% of withdrawal seizures occur 7 to 48 hours after stopping drinking, and the peak time is 13 to 14 hours. During the convulsive activity period, the EEG is usually abnormal, but it can be recovered after a few days. It can manifest as a one-time outbreak but most cases are sudden 2 to 6 outbreaks, sometimes more. A small number of patients develop a sustained state of epilepsy, mostly a major seizure. Local seizures suggest local presence (mostly trauma) in addition to alcohol. About one-third of patients with systemic withdrawal seizures develop a state of tremor and delirium.

Withdrawal response treatment principle

1. Slowly withdraw drug

For adults, addictive drugs should be stopped gradually within 1 week. For those who are frail, addicted, and elderly, in order to avoid cerebrovascular accidents and collapse during drug withdrawal, the drug can be slowly reduced, within 10 days to 2 weeks. Finished within. Vitamin B group, vitamin C and physical support therapy can alleviate the pain during withdrawal, and promote brain nutrition metabolism therapy, such as energy mixture, brain rehabilitation, etc. to help get rid of withdrawal symptoms. It is best to quit drinking or detoxifying in a detox center or a psychiatric ward.

2. Prevention of withdrawal syndrome

May reduce the amount of alcohol or drugs gradually reduce substitutes until they are discontinued.

3. Symptomatic treatment

Oral benzodiazepines such as diazepam, the dose should be gradually reduced; authors of epilepsy may be given phenytoin sodium. The drug is gradually reduced after one week of continuous application until it is discontinued. If necessary, supportive therapies, such as fluid replacement and correction of electrolyte disorders.

In addition to the corresponding drug treatment, if the patient has a strong withdrawal response, the person will provide 24-hour nursing care and communicate with the patient in a timely manner. Build confidence and dispel doubts for patients.