Drug withdrawal

Homeostasis is the body's ability to maintain a certain chemical equilibrium in the brain and throughout the body. For example, the function of shivering in response to cold is to produce heat maintaining internal temperature at around {{convert|37|°C|°F|sigfig=3}}. Homeostasis is impacted in many ways by drug usage and withdrawal. The internal systems perpetuate homeostasis by using different counter-regulatory methods in order to create a new state of balance based on the presence of the drug in the system.{{cite journal | vauthors = Koob GF | title = Drug addiction: the yin and yang of hedonic homeostasis | journal = Neuron | volume = 16 | issue = 5 | pages = 893–6 | date = May 1996 | pmid = 8630244 | doi = 10.1016/S0896-6273(00)80109-9 | s2cid = 7053540 | doi-access = free }} These methods include adapting the body's levels of neurotransmitters, hormones, and other substances present to adjust for the addition of the drug to the body.{{Cite news|url=https://unitedrecoveryproject.com/commonly-abused-drugs/|title=What Causes Drug Withdrawal?|work=Laguna Treatment Hospital|access-date=2018-10-12|language=en-US|archive-date=2018-10-13|archive-url=https://web.archive.org/web/20181013014319/https://unitedrecoveryproject.com/commonly-abused-drugs/|url-status=live}}

{{addiction glossary}}

Examples (and ICD-10 code) of withdrawal syndrome include:

• F10.3 alcohol withdrawal syndrome (which can lead to delirium tremens)
• F11.3 Opioid withdrawal, including methadone withdrawal{{Cite encyclopedia|url=https://medlineplus.gov/ency/article/000949.htm|title=Opiate and opioid withdrawal|encyclopedia=MedlinePlus Medical Encyclopedia|publisher=U.S. National Library of Medicine|language=en|access-date=2019-11-20|archive-date=2019-12-08|archive-url=https://web.archive.org/web/20191208070501/https://medlineplus.gov/ency/article/000949.htm|url-status=live}}
• F12.3 cannabis withdrawal
• F13.3 benzodiazepine withdrawal
• F14.3 cocaine withdrawal
• F15.3 caffeine withdrawal
• F17.3 nicotine withdrawal

As noted above, many drugs should not be stopped abruptly{{cite book | year = 2002 | title = Coming off Psychiatric Drugs | editor = Peter Lehmann | publisher = Peter Lehmann Publishing | location = Germany | isbn = 978-1-891408-98-4 | url = http://www.peter-lehmann-publishing.com | access-date = 2022-05-06 | archive-date = 2019-05-28 | archive-url = https://web.archive.org/web/20190528235308/http://www.peter-lehmann-publishing.com/ | url-status = live }} without the advice and supervision of a physician, especially if the medication induces dependence or if the condition they are being used to treat is potentially dangerous and likely to return once medication is stopped, such as diabetes, asthma, heart conditions and many psychological or neurological conditions, like epilepsy, depression, hypertension, schizophrenia and psychosis. The stopping of antipsychotics in schizophrenia and psychoses needs monitoring.{{cite book |editor1-first=BMJ | editor = Joint Formulary Committee | title = British National Formulary | edition = 57 | date = March 2009 |publisher=Royal Pharmaceutical Society of Great Britain |location=United Kingdom |isbn=978-0-85369-845-6 |page=192 |chapter=4.2.1 |quote=Withdrawal of antipsychotic drugs after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse.}} The stopping of antidepressants for example, can lead to antidepressant discontinuation syndrome. With careful physician attention, however, medication prioritization and discontinuation can decrease costs, simplify prescription regimens, decrease risks of adverse drug events and poly-pharmacy, focus therapies where they are most effective, and prevent cost-related under-use of medications.{{cite journal | vauthors = Alexander GC, Sayla MA, Holmes HM, Sachs GA | title = Prioritizing and stopping prescription medicines | journal = CMAJ | volume = 174 | issue = 8 | pages = 1083–4 | date = April 2006 | pmid = 16606954 | pmc = 1421477 | doi = 10.1503/cmaj.050837 }}

Medication Appropriateness Tool for Comorbid Health Conditions in Dementia{{Cite web|url=http://www.match-d.com.au/|title=MATCH-D Medication Appropriateness Tool for Comorbid Health conditions during Dementia|website=www.match-d.com.au|access-date=2019-06-01|archive-date=2019-05-18|archive-url=https://web.archive.org/web/20190518055626/http://www.match-d.com.au/|url-status=live}} (MATCH-D) warns that people with dementia are more likely to experience adverse effects, and to monitor carefully for withdrawal symptoms when ceasing medications for these people as they are both more likely to experience symptoms and less likely to be able to reliably report symptoms.{{cite journal | vauthors = Page AT, Potter K, Clifford R, McLachlan AJ, Etherton-Beer C | title = Medication appropriateness tool for co-morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel | journal = Internal Medicine Journal | volume = 46 | issue = 10 | pages = 1189–1197 | date = October 2016 | pmid = 27527376 | pmc = 5129475 | doi = 10.1111/imj.13215 }}

The latest evidence does not have evidence of an effect due to discontinuing vs continuing medications used for treating elevated blood pressure or prevention of heart disease in older adults on all-case mortality and incidence of heart attack.{{cite journal | vauthors = Reeve E, Jordan V, Thompson W, Sawan M, Todd A, Gammie TM, Hopper I, Hilmer SN, Gnjidic D | display-authors = 6 | title = Withdrawal of antihypertensive drugs in older people | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | pages = CD012572 | date = June 2020 | issue = 6 | pmid = 32519776 | pmc = 7387859 | doi = 10.1002/14651858.cd012572.pub2 }}{{Update inline|reason=Updated version https://www.ncbi.nlm.nih.gov/pubmed/40162571|date = June 2025}} The findings are based on low quality evidence suggesting it may be safe to stop anti-hypertensive medications. However, older adults should not stop any of their medications without talking to a healthcare professional.

== See also ==

• Chemical dependency
• Drug detoxification
• Drug tolerance
• Hangover
• Neonatal withdrawal
• Post-acute withdrawal syndrome (PAWS)
• Rebound effect

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{{Psychoactive substance use}}

{{Medical resources

| DiseasesDB =

| ICD10 = {{ICD10|F|10||f|10}}.3-{{ICD10|F|19||f|10}}.3

| ICD9 = {{ICD9|292.0}}

| ICDO =

| OMIM =

| MedlinePlus =

| eMedicineSubj = article

| eMedicineTopic = 819502

| MeshID = D013375

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Category:Drug rehabilitation

Category:Substance-related disorders

Category:Withdrawal syndromes