Stimulant Withdrawal & Detox

Stimulants are drugs that increase energy and alertness. They boost metabolism, mask feelings of depression, and can trigger a sense of euphoria. Most prescription stimulants have legitimate medical uses, such as Ritalin and Adderall.
Evidence Based
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Overview: Stimulant Withdrawal & Detox

Many people with attention deficit hyperactivity disorder (ADHD) or ADD take prescription stimulants to help them focus. Although effective for certain medical conditions, some people abuse stimulants without a prescription for recreational reasons. 

Some stimulants are rarely used for medical purposes, such as methamphetamine and cocaine. Others have no medical purpose at all, such as crack cocaine or crystal meth. All stimulants are highly addictive and carry significant health risks if abused.

These drugs affect the brain and central nervous system (CNS). They increase dopamine levels or block the reuptake of the dopamine the brain naturally produces. Many of these drugs trigger an intense high.

In addition to the euphoric feelings stimulant use causes, there are also negative side effects. These include:

  • Paranoia
  • Suicide ideation
  • Increased heart rate and blood pressure
  • Increased risk of seizures
  • Rapid weight loss
  • Delusions
  • Confusion
  • Psychosis
  • Unstable moods
  • Mental health problems
  • Permanent brain damage
  • Extreme depression following the high

According to SAMHSA’s 2015 National Survey on Drug Use and Health, approximately 2.5 million young adults had misused prescription stimulants. Cocaine causes at least 6,000 overdose deaths per year and meth approximately 4,000 per year.

High school and college students are some of the most frequent users of stimulants. This is due to easy access to drugs via prescriptions for themselves or from their peers. Substance use also relieves pressures young adults face from schoolwork and other responsibilities.

Graphic human body showing symptoms.

Symptoms of Stimulant Withdrawal

A stimulant addiction means you have built up a tolerance and requires larger doses to achieve the same effects. Tolerance is when a person does not respond to a drug in the same way they did at first. If you stop taking the drug you will experience withdrawal. The intensity of withdrawal symptoms varies based on the amount and duration of use. 

The brain also learns how to rely on external support to produce dopamine, which means it will be unable to produce a healthy level of dopamine without the drug. 

A person using stimulants can have both a physical and psychological dependence on the drug. If they stop using, a variety of unpleasant withdrawal symptoms will occur. These include:

  • Anxiety
  • Panic attacks
  • Increased appetite
  • Irritability
  • Insomnia
  • Restlessness
  • Mood swings
  • Depression
  • Difficulty concentrating
  • Fatigue
  • Headaches
  • Drug cravings
  • Hallucinations
  • Seizures
  • Psychosis
  • Night terrors
  • Impaired memory
  • Suicidal thoughts or behavior
  • Delusions
  • Disassociation

How Long Do Symptoms Last?

The length of time withdrawal symptoms last when someone stops using stimulants varies from person to person. Factors affecting the length of withdrawal include:

  • Length of time abusing the drug
  • Amount of drug being abuse
  • Method of taking the drug
  • If there is a history of previous addictions
  • If the drug was being abused with other drugs or alcohol
  • Whether they are using a detox tapering schedule
  • Whether there are co-occurring disorders
  • Overall health at the time of withdrawal

The length of withdrawal depends on whether it was a prescription stimulant and if it was taken in an extended-release form.

Graphic of clipboard with checkboxes for timeline.

Stimulant Withdrawal Timeline

Though each person’s withdrawal and recovery differ, the process follows a general timeline:

Days 1 to 3: Crash Phase

Stimulants slowly exit the body. Fatigue and depression arise if the person takes no additional doses. A person’s appetite will also increase. The intensity and duration of the crash phase vary based on the stimulant that was used. Users of crack and cocaine experience the peak of their symptoms during this phase.

Days 4 to 10: Height of Withdrawal Symptoms

This phase varies a great deal based on the drug that was used. People using prescription stimulants such as Ritalin or Adderall tend to experience the peak of their symptoms that last about a week during this time. 

Meth users also experience the peak at this point, and it lasts about 10 days. Users of crack and cocaine tend to experience the worst cravings during this time, although the peak of their withdrawal has already passed. Irritability, restlessness, and lack of focus develop.

Days 11 to 3 Weeks: Symptoms Begin to Diminish

For most people, withdrawal symptoms begin to diminish during this time. Crack and cocaine users might continue to experience severe cravings for several weeks. But in general, the worst is over by this point for those with stimulant addiction (stimulant use disorder).

Cravings and other withdrawal symptoms can last up to six months but will gradually diminish as time passes.

Detoxing From Stimulants

Detox, especially when it is medically supervised, is the safest option for those addicted to stimulants. Detoxing from stimulants is not as physically dangerous as doing so from other substances, but medical intervention might still be necessary. 

However, there are some risks. 

For example, heavy substance abuse of certain stimulants can cause seizures, delusions, and psychosis. No one should attempt to manage these symptoms on their own.

It is common for those detoxing from stimulants to experience negative thoughts and feelings, and possibly depression. Thoughts of suicide can also develop. 

Medical supervision during detox ensures that a person is safe and receives the care they need, both physically and emotionally.

Detox Medications

There are no medications specifically intended to treat stimulant withdrawal, but some doctors prescribe medications “off-label.” This means the medication has not received FDA approval for treating addiction, but it has shown effectiveness in doing so and appears to be safe.

Modafinil is often used during cocaine detoxification. Mirtazapine is used to help those addicted to amphetamines deal with insomnia and depression.

Graphic of hospital.

Additional Stimulant Addiction Treatment Options

In addition to medical detox and medications, several treatment programs are available to help someone during stimulant withdrawal and throughout recovery. This may include inpatient rehab, behavioral therapies, and group therapy sessions.

A tapering schedule can also be effective in helping someone with stimulant addiction. Slowly reducing the amount of drug used is safe, reduces the risk for seizures and other health problems, and improves someone’s long-term odds of sobriety.

Finally, it’s important for someone who was abusing stimulants to understand the reason behind his or her behavior. This makes it easier to manage the addiction and reduces the risk of relapse.


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Resources

https://www.drugabuse.gov/publications/research-reports/methamphetamine/how-methamphetamine-different-other-stimulants-such-cocaine

“CDC Online Newsroom - Press Release - CDC Survey Finds That 1 in 5 U.S. High School Students Have Abused Prescription Drugs.” Www.Cdc.Gov, www.cdc.gov/media/pressrel/2010/r100603.htm.

Medline Plus. Methamphetamine. US National Library of Medicine, medlineplus.gov/methamphetamine.html.

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Updated on: June 25, 2020
Author
Addiction Group Staff
About
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Medically Reviewed: June 1, 2020
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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