Withdrawal symptoms: what to expect and what to do

Stopping a drug or alcohol can trigger real, physical symptoms. Some are uncomfortable but manageable at home. Others can be dangerous and need medical care. This page explains common signs, rough timelines, and clear steps you can take right away.

Common withdrawal symptoms and timelines

Different substances cause different mixes of symptoms. Here are the ones I see most often and when they usually start.

Alcohol: Symptoms often begin 6–24 hours after the last drink. Mild shakiness and anxiety can peak in 24–72 hours. Severe problems like seizures or delirium tremens (confusion, hallucinations, very high heart rate) usually show up 48–96 hours and are medical emergencies.

Opioids (heroin, oxycodone): Short-acting opioids can cause runny nose, yawning, sweating, muscle aches, nausea and diarrhea within 6–12 hours. Symptoms often peak at 24–72 hours and improve over about a week. Some people get lingering low mood and cravings for weeks or months (post-acute withdrawal).

Benzodiazepines (Xanax, Valium): Withdrawal can start 1–3 days after stopping short-acting drugs. Anxiety, insomnia, tremors and, in severe cases, seizures can occur. Symptoms can last weeks or even months; gradual medical tapering is usually needed.

Nicotine: Cravings, irritability, difficulty concentrating and increased appetite often start within hours and peak in the first week. Many people feel better after several weeks, though cravings can persist longer.

Caffeine: Headache, tiredness and irritability can begin 12–24 hours after stopping, peak around 24–48 hours and usually resolve in a few days.

How to stay safe and get help

If you expect withdrawal, tell a doctor. Some cases need supervised detox, especially alcohol and benzodiazepine withdrawal because of seizure risk. For opioids, medication options like methadone or buprenorphine reduce symptoms and cut overdose risk.

Practical steps at home include staying hydrated, eating small meals, resting, and using over-the-counter pain relievers for aches. For nicotine, nicotine replacement or prescription medicines like varenicline or bupropion can help. For alcohol withdrawal, doctors often use benzodiazepines, give thiamine, and monitor vitals.

Go to the emergency room now if you have seizures, severe confusion or hallucinations, chest pain, fainting, uncontrollable vomiting or signs of severe dehydration. Call a local crisis line if you feel you might harm yourself.

Support matters. Ask your doctor about supervised taper plans, outpatient programs, counseling, and local support groups. Recovery is easier with a plan and help. If you’re unsure what to do, contact a healthcare provider and describe your substance, how much you used, when you last used it, and your symptoms—those details guide safe care.