Withdrawal Topics

• depression anxiety
• chemical dependence
• areas of the brain
• nucleus accumbens
• withdrawal syndrome
• strong desire
• dysphoria
• discontinuation
• withdrawal symptoms
• amygdala
• dopamine
• neurologists
• euphoria
• bloodstream
• cortex
• length of time
• declines
• half life
• hunger
• period of time

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Withdrawal, Withdrawal

In order to experience the symptoms of withdrawal, one must have first developed a chemical dependence. This happens after consuming one or more of these substances for a certain period of time, which is both dose dependent and varies based upon the drug consumed.

This is the stage that withdrawal may be experienced upon discontinuation. Some of these symptoms are generally the opposite of the drug's direct effect on the body. Depending on the length of time a drug takes to leave the bloodstream elimination half-life, withdrawal symptoms can appear within a few hours to several days after discontinuation and may also occur in the form of cravings. A craving is the strong desire to obtain, and use a drug or other substance similar to other cravings one might experience for food and hunger.

When withdrawal from any medication occurs it can be harmful or even fatal; hence prescription warning labels explicitly saying not to discontinue the drug without doctor approval.

While neurologists have discovered that addiction encompasses several areas of the brain, the amygdala, Prefrontal Cortex, and the nucleus accumbens are specifically responsible for the pleasurable feelings one may experience when using a mind or mood-altering substance. Within the nucleus accumbens neurotransmitter dopamine, so while specific mechanisms vary, nearly every drug 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 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.

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.

However, the length and the degree of an addiction can be indicative of the severity of withdrawal 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.

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.

Prozac , 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.

This is somewhat similar (though generally less intense and more drawn out) to the 'crash' that 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.

Source: Wikipedia > Withdrawal