Individual with drug addiction continue to use their substances in the face of a long duration of critical consequences in significant areas of their lives, including medical problems, legal problems, relational problems, and employment problems. The drive to use often is stronger than one's love for a significant other or a child; stronger than loyalty to an employer or a friend; and stronger than one's values or even spiritual tenets. Persons with addictive disease continue to use long after any rational individual would choose to do so. This article provides a brief summary of one factor, among many, involved in the power of addictive disease: the role of fear of withdrawal.
Fear of withdrawal is one of the fundamental forces at play in the power of addictive disease, be it alcoholism or drug addiction. Withdrawal in this context is defined to include the physical signs and symptoms of withdrawal usually associated with abrupt cessation of use of a substance, after chronic use to the point of development of tolerance and tissue dependence. For example, here are some of the signs and symptoms associated with withdrawal after physical dependence on alcohol: cravings for alcohol, tremors, sleeplessness, diarrhea, anxiety, sweating, loss of appetite, up to hallucinations and seizures in severe cases.
The withdrawal referred to here also embraces the symptoms of a more subjective nature associated with psychological dependence upon a substance, with obsessive thoughts and preoccupation with the substance. Also included within the withdrawal definition is the apprehension felt by the recovering person that he/she will now have to face all of the pain and vicissitudes of life without the drug used as a primary coping mechanism for years. The individual will be acutely aware of the fact that recovery will require facing the pain and consequences of active addiction (e.g., harm caused to loved ones), again without his/her drug. Often the pain, guilt, remorse, and self-hatred emotionally overwhelm the individual, triggering the coping response of the addict or alcoholic, namely, use of his/her drug of choice.
Withdrawal from physical dependence on opiate drugs such as Vicodin (hydrocodone) or OxyContin (oxycodone)is usually NOT a life threatening experience (absent medical complications), with symptoms similar to a bad case of the flu. Withdrawal from physical dependence on stimulants such as cocaine or methamphetamine, or Ritalin or Adderall, can be serious especially in the presence of medical complications, and the depression that can accompany cessation of use can be severe; a person with thoughts of self harm should seek immediate help from a mental health professional. Withdrawal from dependence on alcohol or sedatives such as the benzodiazepines (for example, Xanax, Ativan, Valium) can be life threatening and the person should seek help from qualified medical professionals.
Fear of withdrawal as defined here is an imposing obstacle to the development of willingness on the part of an addict or alcoholic to choose abstinence and recovery. The cumulative effect of chronic pain and consequences, if properly presented to the addicted individual by a skilled mental health expert with well trained in addictions, with a healthy dose of hope for a way out of the chaos of addiction, can assist the individual to face these withdrawal fears through a successful treatment.