amygdala

Description

Withdrawal is the group of symptoms that occur upon the abrupt discontinuation or decrease in intake of medications or recreational drugs. In order to experience the symptoms of withdrawal, one must have first developed a physical or mental dependence (often referred to as chemical dependency). This happens after consuming one or more substances for a certain period of time, which is both dose dependent and varies based upon the drug consumed. For example, prolonged use of an anti-depressant is most likely to cause a much different reaction when discontinued than the repeated use of an opioid, such as heroin. The route of administration, whether intravenous, intramuscular, oral or otherwise, can also play a role in determining the severity of withdrawal symptoms. There are different stages of withdrawal as well. Generally, a person will start to feel worse and worse, hit a plateau, and then the symptoms begin to dissipate. However, withdrawal from certain drugs (benzodiazepines, alcohol) can be fatal and therefore the abrupt discontinuation of any type of drug is not recommended. The term "cold turkey" is used to describe the sudden cessation use of a substance and the ensuing physiologic manifestations. Substances Examples (and ICD-10 code) of withdrawal syndrome include: F10.3 alcohol withdrawal syndrome (which can lead to delirium tremens) F11.3 opioids, including methadone withdrawal F12.3 cannabis withdrawal F13.3 benzodiazepine withdrawal syndrome F14.3 cocaine withdrawal F15.3 caffeine withdrawal F17.3 nicotine withdrawal ----- SSRI discontinuation syndrome The term "withdrawal" can sometimes be used to describe the results of discontinuing prescription medicine, as in SSRI discontinuation syndrome, though the term rebound effect is also used to characterize these conditions. Overview The sustained use of many kinds of drugs causes adaptations within the body that tend to lessen the drug's original effects over time, a phenomenon known as drug tolerance. At this point, one is said to also have a physical dependency on the given chemical. This is the stage that withdrawal may be experienced upon discontinuation. Some of these symptoms are generally the opposite of the drug's direct effect on the body. Depending on the length of time a drug takes to leave the bloodstream elimination half-life, withdrawal symptoms can appear within a few hours to several days after discontinuation and may also occur in the form of cravings. A craving is the strong desire to obtain, and use a drug or other substance similar to other cravings one might experience for food and hunger. Although withdrawal symptoms are often associated with the use of recreational drugs, many drugs have a profound effect on the user when stopped. When withdrawal from any medication occurs it can be harmful or even fatal; hence prescription warning labels explicitly saying not to discontinue the drug without doctor approval. The symptoms from withdrawal may be even more dramatic when the drug has masked prolonged malnutrition, disease, chronic pain, or sleep deprivation, conditions that drug abusers often suffer as a secondary consequence of the drug. Many drugs (including alcohol) suppress appetite while simultaneously consuming any money that might have been spent on food. When the drug is removed, the discomforts return in force and are sometimes confused with addiction withdrawal symptoms, which they quite properly are not. Withdrawal from drug abuse Central to the role of nearly all drugs that are commonly abused is the reward circuitry or "pleasure center" of the brain. The science behind the production of a sense of euphoria is very complex and still questioned within the scientific community. While neurologists have discovered that addiction encompasses several areas of the brain, the amygdala, Prefrontal Cortex, and the nucleus accumbens are specifically responsible for the pleasurable feelings one may experience when using a mind...