It is common to hear the expression “being with the monkey” when talking about drug addicts who are experiencing tremors, nervousness or outbursts of anger at a time when they do not have drugs.
These are situations in which these people are suffering greatly and experience variable symptoms. It is a colloquial way of talking about withdrawal syndrome, a problem that we are going to talk about in this article
Withdrawal syndrome is understood as the set of symptoms caused in the body physically and mentally dependent on a substance before its abrupt withdrawal. Such withdrawal may refer to a complete cessation of consumption or a reduction in quantity and/or frequency, and the symptoms are not due to other medical or mental illnesses (although it may exacerbate symptoms of some illness).
Generally, the withdrawal of consumption is caused intentionally by the dependent subject, in order to eliminate the aversive consequences that the addiction is causing in his or her life. They can also occur due to involuntary circumstances in which it is not possible to access the substance in question, such as hospitalization, travel or imprisonment. A third option is that the subject cannot acquire it despite not having the will to stop consumption, due to lack of suppliers or economic capacity to acquire it.
Withdrawal syndrome generates a great level of suffering and discomfort The specific symptoms of this type of syndrome will depend on the type of substance being consumed, generally being the opposite of those that would appear with intoxication of said substances. Generally, craving or intense desire and desire for consumption usually appears in response to the discomfort generated by the absence of the substance. Other common symptoms are tremors and spasms, headaches, muscle pain, digestive problems such as nausea and vomiting, dizziness, agitation or hallucinations.
The evolution of the symptoms and their intensity depend not only on the type of drug but also on the type, quantity and frequency of previous consumption, being linked to the level of dependence and addiction presented by the subject. In addition to the drug consumed itself, the problems associated with the withdrawal syndrome will intensify if the cessation of consumption occurs in an environment where it is easy to acquire it. Also the way of seeing the world or of perceiving and facing problems will have an effect, with greater discomfort, for example, inhibited people who do not express their feelings (especially negative ones).
The reason for withdrawal syndrome is something that many people, especially those who suffer from it, wonder. The direct reason is the sudden cessation or reduction of consumption, which has been made in such a way that the body of the subject. The body has become accustomed to the substance, generating a tolerance to it (which in turn is what causes consumption to increase in quantity and frequency) and the body has become accustomed to functioning with the substance.
The body, balanced before the acquisition of dependence, learns to maintain a new balance in which the drug or substance in question comes into play. The substance, which initially served as a reinforcer, over time loses part of this role and becomes something necessary to avoid the discomfort associated with its lack.
A sudden withdrawal causes the body, which depended on said substance, to suddenly find that it is missing something that made it function. The internal balance or homeostasis that the body had learned to maintain with the drug it suddenly becomes unbalanced, generating withdrawal syndrome until it can remain balanced on its own. But depending on how the withdrawal is made, the imbalance can generate very severe repercussions.
The need for gradual withdrawal
It is important to keep in mind that the withdrawal of the substance should not be done suddenly. And despite the fact that cessation of consumption in drug addicts is essential and something that can save their lives (both figuratively and literally), suddenly cutting off the supply of a substance on which our body is dependent can have fatal consequences. . Withdrawal syndrome is not something to be taken as a joke: it is a dangerous reality that in many cases can have permanent consequences, lead to coma and even lead to death
In this sense, the type of drug must be taken into account: Getting rid of coffee is not the same as getting rid of cocaine or heroin Also the existing level of dependency. Withdrawal is necessary, but it must be done in a controlled manner (different drugs are often used, for example), scheduled and gradual to avoid severe physiological effects and reduce the risk of a life-threatening withdrawal syndrome.
It is necessary to let the body get used to functioning without so much substance until it can function completely without it. Sometimes the use of substitute substances may be necessary, such as methadone, as long as substance consumption does not occur but dangerous symptoms are kept at bay, confinement in detoxification centers or hospitalization of the subject to keep them stabilized. In some cases, a subject has been put into an induced coma to have better control of the situation.
Alcohol, benzodiazepines and opiates are some of the main substances with withdrawal syndromes that could be life-threatening, mostly due to cardiorespiratory failure It is therefore necessary to schedule its withdrawal.
Different types of withdrawal syndrome
As we have seen, the type of symptoms will depend largely on the substance, the degree of dependence on it and even the biological characteristics of the dependent person. Below are some of the most well-known withdrawal syndromes included in the DSM-5.
1. Tobacco
The withdrawal syndrome caused by tobacco is probably one of the best known and experienced worldwide, with cessation of consumption being something that many consumers have considered. Irritability, insomnia, anxiety, concentration problems, depression and eating disorders are its main symptoms. It is annoying, but it is one of the least harmful withdrawal syndromes and is usually not dangerous.
2. Alcohol
Chronic alcohol users who stop using this substance may experience different types of withdrawal syndromes of varying severity. Common symptoms are tachycardia and sweating, insomnia, hand tremor s, agitation and anxiety, hallucinations and seizures. In extreme cases it is possible that the subject develops delirium tremens, which can lead to death.
Within this category we include amphetamines, cocaine and other stimulants. Abstinence from these substances generates dysphoric mood, increased appetite, fatigue, nightmares and sleep problems as some of the best-known symptoms.
4. Sedatives, hypnotics and anxiolytics
The use and dosage and following the recommended consumption and withdrawal guidelines avoid this type of withdrawal syndrome, which can occur both in those people who use them therapeutically and in those who do it recreationally and/or without control when consumption is stopped suddenly. Tremors, hyperactivity of the autonomic nervous system, tachycardia, nausea and vomiting, hallucinations, agitation and anxiety are some of the most typical symptoms.
5. Opioids
The sudden withdrawal of opium and its derivatives (such as heroin) generates a withdrawal syndrome with the potential to be fatal. Dysphoria, nausea, pain, diarrhea, fever, insomnia or popular procrastination are some of the common symptoms in subjects with withdrawal from opium derivatives.
6. Cannabis
Cannabis is a substance whose consumption is very popular, especially among young people, and which is generally perceived as harmless. However, recently the existence of a withdrawal syndrome has been described that can occur in subjects who consume daily or almost daily This syndrome is characterized by restlessness, depression, loss of appetite, nervousness and restlessness and sometimes alterations such as fever, spasms, abdominal pain or headache may occur.
7. Caffeine
Although many people may dispute it, frequent, prolonged and daily consumption of caffeine can generate a certain level of dependence on this substance, as well as withdrawal syndrome with its abrupt cessation. Fatigue and sleep, headache, flu symptoms, irritability or dysphoria are typical symptoms of this syndrome.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
