WordNet

pull back or move away or backward; "The enemy withdrew"; "The limo pulled away from the curb" (同)retreat, pull away, draw back, recede, pull_back, retire, move back
remove (a commodity) from (a supply source); "She drew $2,000 from the account"; "The doctors drew medical supplies from the hospitals emergency bank" (同)draw, take_out, draw_off
the termination of drug taking (同)drug_withdrawal
the act of ceasing to participate in an activity
the act of taking out money or other capital
the act of withdrawing blood, tumors, etc.; "the nurse was expert at the withdrawal of blood"
the act of withdrawing; "the withdrawal of French troops from Vietnam"
a retraction of a previously held position (同)backdown, climb-down
avoiding emotional involvement (同)detachment
use recreational drugs (同)do drugs
administer a drug to; "They drugged the kidnapped tourist" (同)dose
a substance that is used as a medicine or narcotic

PrepTutorEJDIC

(…から)…‘を'『引っ込める』《+名+from+名》 / (…から)…‘の'身を引かせる,‘を'退かせる《+名+from+名》 / (…から)…‘を'引き出す,回収する《+名+from+名》 / 〈申し出・約束など〉‘を'取り消す,撤回する / 『引き下がる』;(…から,…へ)退く《+from(into)+名》 / (…から)身を引く《+from+名(doing)》 / よける,身をかわす / 取り消す,撤回する
引っ込めること,引っ込むこと,退くこと / 引き上げ,回収 / 取り消し,撤回
『薬』,薬品,薬剤 / 『麻薬』,麻酔剤 / 〈人〉‘に'薬(特に麻酔剤)を与える / 〈飲食物〉‘に'(麻酔薬・毒薬などの)薬を混ぜる

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/06 23:33:44」(JST)

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Drug 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 and/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. Withdrawal symptoms from opiate abuse (such as heroin/morphine) include anxiety, sweating, vomiting, and diarrhea. Alcohol abuse withdrawal symptoms include irritability, fatigue, shaking, sweating, and nausea. Withdrawal from nicotine brings on irritability, fatigue, insomnia, headache, and difficulty concentrating. Symptoms and body response to the absence can vary from mild discomfort, or to the return of previous underlying medical problems and their respective symptoms. Many legal and unrestricted chemicals and/or substances available without prescriptions and over the counter can cause withdrawal effects when users stop consuming them, even if taken as directed.

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. While it is seldom fatal to the user, withdrawal from opiates (and some other drugs) can cause miscarriage, due to fetal withdrawal. The term "cold turkey" is used to describe the sudden cessation use of a substance and the ensuing physiologic manifestations.

Even once the symptoms of withdrawal have receded, and/or even after a long period of abstinence, a recovering addict can be triggered to re-live his/her withdrawal symptoms through the exposure of a trigger. A trigger is a cue that reminds the recovering addict of the drug. Triggers can be anything from the smell of cigarette smoke for an ex-smoker, or passing by a location that the addict associates with his/her previous experiences using.

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.One of the reasons many recovering addicts that relapse overdose after a period of sobriety is because of a change in tolerance. The addict attempts to use the amount of drug that s/he had previously consumed not realizing that his/her bodies tolerance threshold has lessened. At this point,the point at which an addicts tolerance has grown to the point that the addict is needing more and more of the drug to feel the same affect, 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. However, the symptoms associated with sudden discontinuation of many prescription medications are, due to differences in the underlying physiology, and the absence of cravings, not properly considered "withdrawal".

The symptoms from withdrawal may be even more dramatic when the drug has masked prolonged malnutrition, disease, chronic pain,infections(common in intravenous drug used) 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.

Substances[edit]

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.

Prescription medicine[edit]

As noted above, many drugs should not be stopped abruptly^[1] 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, hypertension, schizophrenia and psychosis. With careful physician attention, however, medication prioritization and discontinuation can decrease costs, simplify prescription regimens, decrease risks of adverse drug events and polypharmacy, focus therapies where they are most effective, and prevent cost-related underuse of medications.^[2]

Sudden cessation of the use of an antidepressant can deepen the feel of depression significantly (see "Rebound" below), and some specific antidepressants can cause a unique set of other symptoms as well when stopped abruptly.

Discontinuation of selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed class of antidepressants, (and the related class serotonin-norepinephrine reuptake inhibitors or SNRIs) is associated with a particular syndrome of physical and psychological symptoms known as SSRI discontinuation syndrome. Effexor (venlafaxine) and Paxil (paroxetine), both of which have relatively short half-lives in the body, and are some of the most likely antidepressants to cause withdrawals. The worst withdrawal symptoms from a prescription drug that are documented are from the drug Cymbalta (duloxetine) which are sometimes referred to as "nightmare-ish" due to the ill effects and their prevalence^{[citation needed]}. Prozac (fluoxetine), on the other hand, is the least likely of SSRI and SNRI antidepressants to cause any withdrawal symptoms, due to its exceptionally long half-life.

References[edit]

^ Peter Lehmann, ed. (2002). Coming off Psychiatric Drugs. Germany: Peter Lehmann Publishing. ISBN 1-891408-98-4.
^ Alexander, GC; Sayla MA, Holmes HM, Sachs GA (11 April 2006). "Prioritizing and stopping prescription medicines.". Canadian Medical Association Journal. 8 174 (8): 1083–1084. doi:10.1503/cmaj.050837. PMC 1421477. PMID 16606954. Retrieved 2011-11-11. Cite uses deprecated parameters (help)

External links[edit]

Fact sheets, detox information and harm reduction strategies concerning illicit drugs

UpToDate Contents

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English Journal

Prevalence and correlates of street-obtained buprenorphine use among current and former injectors in Baltimore, Maryland.

Genberg BL, Gillespie M, Schuster CR, Johanson CE, Astemborski J, Kirk GD, Vlahov D, Mehta SH.SourceJohns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615N. Wolfe Street, Baltimore, MD 21205 USA.
Addictive behaviors.Addict Behav.2013 Dec;38(12):2868-73. doi: 10.1016/j.addbeh.2013.08.008. Epub 2013 Aug 17.
OBJECTIVES: There are few systematic assessments of street-obtained buprenorphine use from community-based samples in the United States. The objective of this study was to characterize the prevalence, correlates, and reasons for street-obtained buprenorphine use among current and former injection dr
PMID 24018232

A cardiomyocyte-based biosensor for antiarrhythmic drug evaluation by simultaneously monitoring cell growth and beating.

Wang T, Hu N, Cao J, Wu J, Su K, Wang P.SourceKey Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, PR China.
Biosensors & bioelectronics.Biosens Bioelectron.2013 Nov 15;49:9-13. doi: 10.1016/j.bios.2013.04.039. Epub 2013 May 3.
Drug-induced cardiotoxicity greatly endangers the human health and results in resource waste. Also, it is a leading attribution to drug withdrawal and late-stage attrition in pharmaceutical industry. In the study, a dual function cardiomyocyte-based biosensor was introduced for rapid drug evaluation
PMID 23708811

Japanese Journal

刑事施設における薬物依存離脱指導対象者用アセスメントに係る取組について

山本麻奈,猪爪祐介,松嶋祐子
刑政 124(1), 92-100, 2013-01-00
NAID 40019537204

分子標的治療の副作用対策Sorafenibの副作用とその対策 (第61回日本泌尿器科学会中部総会シンポジウム2「分子標的薬治療の副作用対策」)

中山雅志,新井康之,西村和郎
泌尿器科紀要 = Acta urologica Japonica 58(11), 635-637, 2012-11-00
… This indicated that it is very important to prevent and manage side effects of sorafenib avoiding drug withdrawal or dose reduction. …
NAID 40019497562