Withdrawal occurs when an addict has used a drug long enough to create a physical dependence within the brain and body. When the drug is discontinued, the user goes into physical withdrawal; symptoms differ depending on the drug, but the general experience is the opposite of the drug effects.
For most abused substances, physical withdrawal is limited to a week. It takes this long to purge the drug from the system and recover from any residual physical effects. Colloquially called dopesickness, withdrawal is often the first huge hurdle for the addict to overcome. It is a deeply unpleasant experience, and with some drugs such as alcohol or benzodiazapines (i.e. Xanax or Valium), unsupervised withdrawals can lead to seizures and even death.
Withdrawal symptoms differ widely from drug to drug. For singular descriptions, please see our list of addiction types.
Craving is a phenomenon that occurs both during and long after withdrawal. At first, it is predominantly physical craving – addicts know that the symptoms of withdrawal will ease if they, “just take one more dose.”
Even before any real withdrawal attempt, most addicts have had some experience with cravings. For many short acting drugs, a cycle of desire and satisfaction comes even between doses in one session of using. Crack cocaine is particularly good at eliciting cravings in as short as fifteen minutes.
But cravings go beyond a mere desire for more drugs to ease the suffering of withdrawal. Craving is really a psychological problem that can be triggered long after detox is complete. For those who have never had the experience, it is hard to describe. This is not like a craving for ice cream late at night. It is more like the craving for air when you’ve held your breath too long or the unstoppable sobbing of grief.
Craving is not under willed control. This is not something that can be stopped by simply reasoning about it. It is more powerful than that. In some cases, addicts will talk about their craving as, “Something that just took over; I couldn’t help myself.”
The good news is that any particular episode of strong craving will pass with time. The bad news is that addicts are vulnerable to this long after they have stopped actively using. It is likely the primary reason that relapse rates are so high after treatment. Current therapies for addiction focus on retraining thinking patterns to help avoid acting out on cravings when they occur.
photo by Jason VanDorsten