Dr. Malasri Chaudhery-Malgeri (Dr. Mala) is the Chief Clinical Officer at Recovery.com, where she develops and delivers unbiased and educational resources for those seeking addiction and mental health treatment. A graduate of The University of Michigan (Ann Arbor) and Wayne State University (Detroit), she is an expert with over 20 years of experience in TBI, PTSD, Military Psychology, Marriage & Family Psychology, Rehabilitative Therapy, Integrative & Collaborative Program Development, Business Psychology, and more. She has helped individuals of diverse age ranges and backgrounds, including the military, executives and business professionals, political figures, rural communities, native populations, LGBTQ+ populations, athletes, and couples and families. She is also a motivational speaker and presenter.
We often joke about going through withdrawal from a specific person, food, or TV show. While withdrawal describes something being removed or taken away, it also specifically refers to a set of symptoms a person can experience upon stopping an addictive substance or behavior, such as drugs, alcohol, and gambling.
What is drug / alcohol withdrawal?
Drug and alcohol withdrawal occurs when a person stops using drugs or drinking after a period of regular use.
Withdrawal is one of the diagnostic criteria for a substance or alcohol use disorder since it is a sign that a person has become physically and/or psychologically dependent. Withdrawal is often what keeps a person trapped in addiction because one of the quickest ways to relieve withdrawal is to use or drink again. Many will continue drugs and alcohol not for the positive, pleasurable effects, but for avoiding the negative effects of withdrawal.
A person does not necessarily have to be an “addict” or “alcoholic” to experience withdrawal and not everyone will experience withdrawal symptoms.
Common Withdrawal Symptoms
Symptoms can be both physical and psychological. Symptoms and intensity of symptoms vary from person to person. Age, how long someone has been using drugs or alcohol, how much and how frequently, and more are factors for withdrawal.
Nausea
Vomiting
Sleep Disturbances (e.g. insomnia)
Agitation, irritability
Anxiety
Depression
Discomfort (malaise)
Muscle aches
Why is withdrawal so uncomfortable?
Withdrawal is so uncomfortable because the body adapts to the drug being present and it takes time for the body to readjust when the drug is no longer present. Withdrawal symptoms typically are the exact opposite of symptoms felt from the drug. For example, if a drug relaxes your system, you may feel anxiety and irritability upon stopping the drug.
Can you die from withdrawal?
The short answer is yes, you can die from withdrawal. However, most substances produce uncomfortable, non life-threatening symptoms. Alcohol and benzodiazepines are substances that can be very dangerous to stop “cold turkey” or abruptly, so it’s important to be under medical supervision for alcohol and benzodiazepine detox.
A person may know they have a drug problem if they have become dependent on a drug and feel like the drug is needed for functioning. Another way an individual can tell if their drug use is causing a problem is if they are experiencing negative consequences in their home, work, or personal relationships.
When does using drugs become a problem?
Drug usage in someone’s life becomes a problem when it negatively affects an individual’s mental, emotional, and physical health. This may manifest as an addiction, withdrawal symptoms, illegal activity, or other negative consequences in their life or the lives of family and friends.
Drugs can also become a problem in someone’s life when they depend on the drug for achieving personal fulfillment at the expense of themselves and/or others.
DSM-V and ICD-10 criteria for Substance Use Disorders
The table below features the DSM-V and ICD-10 which can be used as a guide to determine if drug usage may be a problem in your life or your loved ones life.
This table is not to be used for a self-diagnosis. Please seek help from a mental health professional for a real diagnosis if you feel like you or your loved one may be experiencing a drug problem.
DSM-V
ICD-10
The presence of at least 2 of the symptoms in the chart below indicates an individual may have a Substance Use Disorder. The severity is defined as: Mild: 2-3 symptoms, Moderate 4-5 symptoms, and Severe 6+ symptoms.
The presence of 3 or more of the following should be present together for at least 1 month, or repeatedly during a 1 year period.
In the past year, have you?
Have you had?
Had times when you ended up taking the substance more, or longer, than you intended?
A strong desire or sense of compulsion to take the psychoactive substance?
More than once wanted to cut down or stop taking the substance, or tried to, but couldn’t?
Difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use?
Spent a lot of time taking the substance? Or being sick or getting over other aftereffects?
A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms?
Wanted the substance so badly you couldn’t think of anything else?
Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses?
Found that taking the substance interfered with taking care of your home or family? Or caused job troubles? Or school problems?
Progressive neglect of alternative pleasures or interests because of psychoactive substance use?
Continued to take the substance even though it was causing trouble with your family or friends?
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to take the substance?
More than once gotten into situations while or after taking the substance that increase your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area?)
Continued to take the substance even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to take more of the substance much more than you once did to get the effect you want? Or found that your usual drug dose had much less effect than before?
Found that when the effects of drugs were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating or racing heart?
DSM-V contains a list of criteria that helps determine if an individual may have a Substance Use Disorder. The DSM-V is the Diagnostic and Statistical Manual of Mental Disorders developed by the American Psychiatric Association in 1952. As research and data continues, the APA updates the DSM with current information which is why there is the letter V for the 5th edition.
ICD-10 contains a list of criteria that helps determine if an individual may have a Substance Use Disorder. The ICD-10 is the International Classification of Diseases developed by the United States National Center for Health Statistics (NCHS) in 1893. As research and data continues, the APA reviews and updates the ICD with current information which is why there is the number 10 for the 10th revision.
How Can You Find Out?
Many will say if you’re questioning, then that means you have a drug problem and should seek help. Here are a few other ways you can find out if you have a drug problem.
Talk to Your GP
Talk to your general practitioner about your drug use and be honest. GPs can conduct an assessment and refer you to another health professional or level of care if needed.
Get an Assessment with a Mental Health Professional
The best and recommended way to know if you have a drug problem is to get an assessment with a mental health professional. Since they’re experts, they’ll be able to assess the severity of a substance use disorder and recommend the level of treatment you need. You can talk to your GP about a mental health assessment or find other providers who can give one.
Try Minimizing or Stopping Drugs
Note: this is not safe if you consistently take drugs, as drug withdrawal can be life-threatening. If you have not become dependent on drugs though and think you may have a problem, see if you can go without the drug or significantly reduce your drug intake. Does it cause anxiety? Are you struggling to stop?
Take an Online Quiz
Here are a few common online quizzes regarding drugs. The general quizzes below are not meant to be a diagnosis, but more of a spectrum guide of your drug usage.
A 29 question quiz built by people in recovery in Narcotics Anonymous to help determine if you may be addicted to drugs. https://m.na.org/?ID=ips-an-an-IP7
Alcohol is a substance that may become a problem in someone’s life regardless of how much alcohol one drinks or how frequently (although regular and heavy use generally indicate a problem). Alcohol misuse may mean drinking over the recommended guidelines, becoming physically dependent on alcohol, or drinking for emotional reasons.
Alcohol use disorders are determined through an assessment by a health professional who has gone through training to diagnose based on standards provided by credited research.
What makes alcohol a problem?
Alcohol is so common and seemingly everyone drinks alcohol, so at what point can it become a problem?
A person may notice they have an alcohol problem if they start neglecting life responsibilities to consume alcohol. They may notice alcohol has become a problem in their life when they feel the need to drink alcohol to do daily functions, cope, grieve, or numb their emotions.
Another way someone may notice that alcohol has become a problem is if their behavior causes negative consequences in their life or the lives of others.
It is important to note that someone does not have to be an “alcoholic” to have a problem with alcohol. Alcohol use disorders are based on the individual’s assessment.
DSM-V and ICD-10 criteria for Alcohol Use Disorders
The table below features the DSM-V and ICD-10 criteria for an alcohol use disorder; both are beneficial to use as a guide for if alcohol may be a problem in your life or your loved one’s life.
This table is not to be used as a self-diagnosis. Please seek help from a health professional for more detailed information and for a diagnosis about a possible alcohol use disorder that you or your loved one may be experiencing.
DSM-V
ICD-10
The presence of at least 2 of the symptoms in the chart below indicates an individual may have an Alcohol Use Disorder (AUD). The severity of the AUD is defined as: Mild: 2-3 symptoms, Moderate 4-5 symptoms, and Severe 6+ symptoms.
The presence of 3 or more of the following should be present together for at least 1 month, or repeatedly during a 1 year period.
In the past year, have you?
Have you had?
Had times when you ended up drinking more, or longer, than you intended?
A strong desire or sense of compulsion to take the psychoactive substance (alcohol)?
More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
Difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use?
Spent a lot of time drinking? Or being sick or getting over other aftereffects?
A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms?
Wanted a drink so badly you couldn’t think of anything else?
Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses?
Found that drinking-or being sick from drinking-after interfered with taking care of your home or family? Or caused job troubles? Or school problems?
Progressive neglect of alternative pleasures or interests because of psychoactive substance use?
Continued to drink even though it was causing trouble with your family or friends?
Persistent substance use despite clear evidence of overtly harmful consequences (mental and/or physical?)
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
More than once gotten into situations while or after drinking that increase your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area?)
Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to drink much more than you once did to get the effect you want? Or found that your usual number of rinks had much less effect than before?
Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating or racing heart?
DSM-V is a list of criteria that helps determine if an individual may have an Alcohol Use Disorder. The DSM-V is the Diagnostic and Statistical Manual of Mental Disorders developed by the American Psychiatric Association in 1952. As research and data continues, the APA updates the DSM with current information which is why there is the letter V for the 5th edition.
ICD-10 is a list of criteria that helps determine if an individual may have an Alcohol Use Disorder. The ICD-10 is the International Classification of Diseases developed by the United States National Center for Health Statistics (NCHS) in 1893. As research and data continues, the APA reviews and updates the ICD with current information which is why there is the number 10 for the 10th revision.
How Can You Find Out?
Many will say if you’re questioning, then that means you have an alcohol problem and should seek help. Here are a few other ways you can find out if you have an alcohol problem.
Talk to Your GP
Perhaps one of the best and easiest ways to find out if you have an alcohol problem is to candidly talk to your general practitioner about your alcohol use. GPs can conduct an assessment and refer you to another health professional or level of care if needed.
Get an Assessment with a Mental Health Professional
Another recommended way to know if you have an alcohol problem is to get an assessment with a mental health professional. Since they’re experts, they’ll be able to assess the severity of an alcohol use disorder and recommend the level of treatment you need. You can talk to your GP about an assessment or find other providers who can give one.
Try Minimizing or Stopping Alcohol
Note: this is NOT safe for everyone, especially if you consistently drink, as alcohol withdrawal can be life-threatening. If you casually drink though and think you may have a problem, see if you can go without alcohol or significantly reduce your alcohol intake. Does it cause anxiety? Are you struggling to stop?
Take an Online Quiz
Here are a few common online quizzes regarding alcohol consumption. The general quizzes below are not meant to be a diagnosis, but a guide for alcohol use.
A 10 question quiz that helps determine if alcohol use in your life is causing you to be at low risk, medium-risk, or high risk for having an Alcohol Use Disorder. alcohol.org
A 15 question quiz that helps determine if alcohol use is a problem in your life. All questions are either true or false. allthetests.com
A 11 question quiz that uses the DSM-V approach to determine if you may have an alcohol use disorder. This quiz has the results of the answered questions on a spectrum of mild, moderate, or severe. menshealth.com
