Almost 7.5 million Americans struggled with illicit drug addiction in 2016, per the National Survey on Drug Use and Health (NSDUH). Addiction is a brain disease that relates to changes in brain chemistry and functions as a result of chronic drug use. An inability to control and regulate drug use is one of the major signs of addiction.
Another aspect of addiction is often drug dependence. This is actually a physical change in the brain and body that involves the way that neurotransmitters, or chemical messengers, are stimulated, reabsorbed, and sent throughout the central nervous system. Neurotransmitters help to regulate emotions, autonomic bodily functions such as those related to the stress response (body temperature, respiration, blood pressure, and heart rate), memory and learning abilities, and the reward processing center of the brain. Psychoactive drugs interfere with the way that these naturally occurring chemical messengers work in the brain.
Many illicit drugs affect levels of dopamine and serotonin, which, in turn, affects moods, movement functions, and sleep capabilities. With regular drug use, the brain can get confused and out of balance, and then it struggles to keep its chemical makeup stabilized. When drugs then process out of the body, withdrawal symptoms occur, as the brain works to catch up and regulate things again.
Detox is the purging of toxins from the body, and cold turkey refers to stopping drug use suddenly. Some drugs, such benzodiazepines, interact with neurotransmitters that affect functions of the central nervous system in such a way that when they process out of the body, the brain’s attempts to restabilize can cause an unsafe spike, resulting in potentially life-threatening physical side effects.
Regularly using drugs often leads to physical dependence. When the substances are not present, the brain has a hard time working the way it is meant to, and it can take a while for it to restore natural order again. This detox process can be uncomfortable, and it often includes many physical and emotional withdrawal symptoms.
Opioids, alcohol, and benzodiazepines (benzos) can have significant withdrawal symptoms and should not be stopped suddenly. Stimulant drug withdrawal symptoms are largely emotional, but they can be significant as well. Chronic marijuana use can also lead to drug dependence, and detox may include uncomfortable physical and emotional side effects in some instances.
Cold-turkey detox can be drastic for the brain and body. Typically, it is more beneficial to participate in a specialized detox program that will involve medications or slowly tapering drugs out of the body to minimize shock to the system.
If you do plan on trying cold-turkey detox, you should know what to expect and how to keep yourself safe in the process. Again, this is not recommended without consulting a physician first. In cases of opioid, benzodiazepine, and alcohol withdrawal, medical detox is required.
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Opioid drugs include both illegal drugs like heroin and illicit fentanyl and also prescription narcotic pain relievers like morphine and oxycodone. Opioids block pain receptors in the brain and also fill opioid receptors. This creates a surge of dopamine that creates feelings of happiness and pleasure. The central nervous system is depressed by opioid drugs, which means that breathing, blood pressure, pulse, and body temperature are all suppressed.
While taking an opioid drug, it is common to feel mellow, relaxed, happy, drowsy, uncoordinated, and sluggish. Users often can’t think clearly or remember things properly. When opioid drugs wear off, the opposite feelings can creep in.
Opioid drugs are considered to be extremely addictive. Even relatively short-term use of an opioid for medical purposes can lead to physical and psychological drug dependence. The prescribing information for OxyContin (oxycodone), published by the U.S. Food and Drug Administration (FDA), warns that it is not a drug that should be stopped suddenly, as this can lead to serious withdrawal side effects.
After dependence has formed, cold-turkey detox from an opioid drug can have many physical and emotional side effects, per the U.S. National Library of Medicine (NLM), such as:
Depression, irregular blood pressure and heart rate, irritability, restlessness, trouble thinking clearly, and memory lapses along with drug cravings are additional side effects of opioid drug withdrawal.
These withdrawal symptoms can start within about 12 hours of the last dose of an opioid drug and generally peak in the first few days. The major physical symptoms generally start to taper off after the first five-to-seven days, but emotional side effects, including mood swings, insomnia, depression, cravings, and anxiety, can continue for weeks or even months.
Stopping an opioid drug suddenly can be intense, so it is not advised. If you opt to do so anyway, it is important to ensure that you are in a stable environment surrounded by supportive people who can help you to remain physically safe and also avoid a return to drug use, or relapse. Hot baths, massage, and over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) can help to relieve physical pain and tension during detox.
Consume foods that are easily digested, and drink plenty of water to purge toxins from the body. OTC nausea and gastrointestinal medications may help to settle your stomach during detox.
Another important aspect is sleep. Disrupted sleep is a common issue during detox. Anything you can do to relax and encourage restful sleep can help you to be better equipped to manage withdrawal. Yoga, mindfulness meditation, and breathing exercises can be great relaxation tools.
“Again, cold-turkey detox from opioids is not recommended. Most doctors will encourage medical detox under the watchful eye of a trained medical professional who can help manage withdrawal symptoms safely to minimize the chance for relapse.”
Benzos are tranquilizers, and sedative drugs used to treat anxiety, tension, seizures, and insomnia. Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam) are common benzodiazepine drugs. These drugs are commonly prescribed, highly addictive, and commonly misused, the U.S. Drug Enforcement Administration (DEA) explains.
Benzos work by increasing levels of GABA (gamma-Aminobutyric acid) in the brain. GABA is a neurotransmitter that helps to calm the body’s stress response and, therefore, works to slow down respiration, lower blood pressure, and decrease heart rate, while lowering body temperature and promoting relaxation and feelings of calm. Benzos reduce anxiety by slowing nerve firings in the brain and altering brain chemistry in such a way that the central nervous system is suppressed, helping you to feel more at ease and improving sleep capabilities.
The FDA warns that even short-term medical use of the popular benzo Xanax can cause drug dependence, and stopping it cold turkey at this point can cause potentially life-threatening withdrawal symptoms such as:
The intensity of benzo withdrawal during detox is related to how significant the drug dependence is. For example, if you take a lot of Valium every day for several months (especially if you are misusing and snorting, injecting, or smoking it), you are likely to be more heavily dependent on the drug; therefore, withdrawal is probably going to be more intense. Use of benzos in combination with other drugs or alcohol, or the presence of other medical or mental health issues, can also influence the severity of withdrawal.
If you have developed a dependence on any benzodiazepine drug, cold-turkey detox is not recommended. A medical detox program that can offer around-the-clock medical monitoring, emotional support, and constant supervision in a safe and stable environment is ideal for benzodiazepine withdrawal.
Instead of going cold turkey, benzo withdrawal can be managed by initiating a taper —slowly reducing the amount of medication you are taking each day. Medications to address specific side effects can help, as can holistic measures to reduce physical discomfort and ease tension and stress.
Stimulants are a class of drugs that can be extremely addictive, such as cocaine, methamphetamine (meth), and prescription ADHD medications containing amphetamines (such as Adderall and Ritalin). These substances increase focus, attention, and alertness while raising blood pressure, body temperature, and heart rate. They can also make you feel good, producing an intense and pleasurable “high.”
When these drugs wear off, though, the opposite effects can occur, and the “crash” can cause extreme lows. Repeated use of a stimulant drug also can lead to drug dependence. The FDA warns that Adderall is not meant to be taken long-term because of the high risk for drug dependence and difficult withdrawal side effects, for instance. Cold-turkey detox from a stimulant drug typically involves severe emotional withdrawal side effects including:
The low moods and problems with feeling pleasure can be especially difficult during cold-turkey detox and withdrawal from a stimulant drug.
Stimulant drug withdrawal symptoms can start within several hours of the last dose, peaking within the first three days, and then starting to decrease after about a week. Mood swings, cognitive issues, sleep problems, and cravings may last for a few weeks or months after detoxing from a stimulant drug.
During the first few days to a week of stopping a stimulant drug, it is vital to remain free from temptation and to try and stay as occupied mentally as possible. Surround yourself with a stable support system and consider natural and OTC supplements and methods to enhance moods and promote relaxation. Go for walks, exercise, do yoga, get a massage, talk to a friend, avoid caffeine, eat healthy, paint, draw, or write, listen to or play music, and keep busy during cold-turkey detox for a stimulant. Minimizing relapse and keeping depression at bay are some of the most important things to consider during stimulant withdrawal.
Hallucinogenic drugs like LSD (d-lysergic acid), PCP (phencyclidine), and magic mushrooms (psilocybin) are not considered to be physically addictive and typically not thought to cause drug dependence. This means there are no associated physical withdrawal symptoms, and it should be safe to detox from these substances cold turkey.
The trip from a hallucinogenic drug can last for hours and be unpredictable, however, so it is beneficial to ensure that you are in a safe place during the comedown. You may want to sleep more than normal, and your appetite may be affected during detox. Cravings shouldn’t be an issue, but a recurrence of the distorted senses or feelings during the trip (a flashback) can happen weeks, months, or even years after taking a hallucinogen. The National Institute on Drug Abuse (NIDA) warns that long-term side effects of hallucinogenic drug use are relatively unknown.
Marijuana has hallucinogenic properties, but the drug also suppresses the central nervous system, reducing anxiety, lowering tension, and promoting relaxation. NIDA explains that the drug can be addictive, and dependence on marijuana can form with chronic use.
Cold-turkey detox from marijuana is likely to include both physical and emotional side effects, the most noticeable being irritability, disrupted sleep, anxiety, and cravings, the Iranian Journal of Psychiatry publishes.
Headaches, restlessness, decreased appetite, depression, tremors, stomachache, tension, and concentration issues are common during marijuana withdrawal.
Cold-turkey detox from marijuana can be aided through supportive care. Staying active, eating nutritious and balanced meals, being around encouraging people who want to help you remain abstinent, getting enough sleep, staying hydrated, and participating in engaging hobbies can be great tools during marijuana withdrawal.
Withdrawal symptoms usually start within a day or two of stopping marijuana cold turkey, peak in just under a week, and start to improve after that, the BC Medical Journal explains.
Groups like Marijuana Anonymous (MA) can provide tips for minimizing relapse and offer peer support during cold-turkey detox and into recovery.
The first week of cold-turkey detox is typically the most intense part when the withdrawal symptoms are the most significant. It is important to be supported and cared for during this time.
A medical detox program is typically considered the optimal environment for withdrawal. A medical detox facility provides the highest level of support, medical care and supervision, and safety while drugs process out of the body. Vital signs can be monitored around the clock, and medications can be used to ease withdrawal symptoms.
Opioids and benzos are generally not stopped cold turkey during detox. Instead, they are slowly weaned out of the body using a controlled taper that lowers the dosage safely instead of just stopping the drug use suddenly. This can limit shock on the body and lower the chances of complications.
Cold-turkey detox can be uncomfortable on many levels and even dangerous. Possible side effects include:
A specialized detox program is preferred over trying to detox from drugs cold turkey on your own. Medical detox allows the brain and body time to stabilize in a safe environment before proceeding into a specialized drug addiction treatment program. Detox must be followed by comprehensive treatment to address the underlying reasons behind the substance abuse.
(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
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(January 2013). Benzodiazepines. Drug Enforcement Administration from https://www.deadiversion.usdoj.gov/drug_chem_info/benzo.pdf
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(January 2016). What Are Hallucinogens? National Institute on Drug Abuse from https://www.drugabuse.gov/publications/drugfacts/hallucinogens
(June 2018). Is Marijuana Addictive? National Institute on Drug Abuse from https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive