acute withdrawal

How Long Do Cravings Last After You Stop Using?

“I still have strong cravings to use, so my question is, does it get easier with time and treatment, or will I feel like this forever?”

The cravings that you feel should moderate soon.  It would be nice to be able to give you a simple yes or no, but you need to know a bit about what addiction actually is before you get our answer.

Drugs (including alcohol) make us feel good by imitating or increasing the levels of chemicals in the brain that act on the brain’s reward center. Different drugs do it in varied ways, but the overall effect is to overstimulate that part of the brain that gives us pleasurable sensations.

When over-stimulation occurs, our bodies try to bring things back into balance by reducing the natural production of those chemicals (neurotransmitters). Often, when the drugs wear off, we feel uncomfortable until the natural production of the chemicals resumes. We call this period of withdrawal a “hangover.”

With continued presence of the drugs, the body takes further steps: it begins to increase the number of receptor sites for the specific neurotransmitters in order to use up the surplus. Because of this, continued drug use causes “tolerance.” We need more of the drugs to fill up those extra hungry receptors, and we begin to feel uncomfortable when we don’t have them present in our bodies, or if they are present at too low a level. The process of addiction has begun.

Further drug use doesn't only increase the receptor sites. In its attempts to bring things back to normal, the brain slows production of the natural neurotransmitters. That means that when we stop the drugs, there are insufficient natural neurotransmitters, and we feel cravings and other symptoms of acute withdrawal. These vary, depending on how the drugs affected us to begin with, but they are generally the opposite of however we felt when we were using.

These feelings are most acute during the time the drugs are leaving our bodies, and begin to subside within days. However, the fun isn’t over. As George Carlin said, “Just because the monkey’s off your back, it doesn’t mean the circus has left town.” We will continue to feel discomfort until the body has shut down the extra receptor sites so that they are no longer begging for drugs, and until the natural production of neurotransmitters has resumed. This can take several months, and is referred to as Post-Acute Withdrawal.

Many authorities believe that the extra receptor sites just shut down, and don’t go away. They believe that they can easily be re-activated if drugs are reintroduced into the body.  That certainly seems to fit what we observe in real life.  That’s why we recommend abstinence. In most addicts, any drug use seems to slow and soon reverse the recovery process.

Because of this continued potential for discomfort, if we don’t take care of ourselves physically and mentally during the post-acute period, our risk of relapse is high. However, the discomfort tends to come and go, with good days and bad. Eventually the good days become more common, and the bad ones tend to occur less often and with reduced discomfort, until things are more-or-less back to normal.

You can most certainly look forward to a time when you no longer have the cravings, and those that you have will begin to ease off within a few more days. If you stay clean, eventually the discomfort will disappear entirely. Naturally, as addicts we want to feel better immediately, but it doesn’t work that way. We spent months or years getting our bodies used to drugs, so it’s hardly surprising that it takes quite a while to get over the effects.