There are different stages to withdrawal. Detox or acute withdrawal is the period of time it takes for a drug or substance to be completely eliminated from a person’s system. Withdrawal or post-acute withdrawal is the time when the person is experiencing uncomfortable symptoms because their body is adjusting to living without the drugs. Post-acute withdrawal can last a couple of weeks or a couple of months after detox.

Insomnia is one of the most common symptoms associated with post-acute withdrawal from pretty much any substance. When the person in withdrawal can’t get enough sleep, it makes the other symptoms even more intolerable as there is no respite. Insomnia is also responsible for causing exhausting, a suppressed immune system, higher chance of falling ill and higher stress levels. This stress, which already exists in the post-acute withdrawal stage, is exacerbated by the insomnia, and the person can lapse into using drugs again.

Causes of Insomnia

What causes insomnia during post-acute withdrawal? When one is developing a substance abuse disorder, the stage is already set for suffering insomnia in post-acute withdrawal. During the use and abuse of substances, your brain slows down the production of dopamine. This is due to the fact that taking drugs regularly is already providing you with more than enough dopamine to make up for what the brain normally supplies. Dopamine causes the person taking drugs to not only feel high, but also regulates their mood. Thus, in post-acute withdrawal, your brain needs enough time – 4 to 6 weeks – to start producing enough dopamine again. The lack of dopamine is what increases the stress levels and puts the body in a ‘fight or flight’ mode, until the dopamine is regulated again.  

According to the National Sleep Foundation, insomnia can be caused by:

  • Anxiety
  • Depression
  • Feelings of being overwhelmed
  • Tension
  • Worrying about the past or the future

All of these triggers for insomnia can be easily caused by post-acute withdrawal.

Treatment for Insomnia

Can insomnia be treated with medication? Yes it can be. There are some substance-specific treatments available for those experiencing insomnia. Benzodiazepines and Ambien can be helpful, though some patients with alcohol use disorders are at increased risk for benzodiazepine abuse. Or there are anticonvulsants like carbamazepine and gabapentin, which may also be helpful. Other medication used to treat insomnia are tricyclic antidepressants like amitriptyline and doxepin. However, if the person was addicted to alcohol, the alcohol-induced changes in liver metabolism make it hard to judge the proper dosage.

There are medications recommended for insomnia treatment regardless of which substance was being abused. However, these should only be taken after you’ve consulted with a doctor.

  • Benzodiazepines such as flurazepam, clonazepam, quazepam, lorazepam, and alprazolam can be used for withdrawal during post-acute withdrawal. Benzodiazepines come with a risk of tolerance and dependence.
  • Non-benzodiazepine hypnotics like zolpidem, zaleplon, eszopiclone, and ramelteon are the preferred treatment for insomnia. These medications do come with side effects that include drowsiness, dizziness, fatigue, headache, and diarrhea.
  • Over-the-counter antihistamines such as diphenhydramine, doxylamine, chlorpheniramine, and hydroxyzine can make you drowsy and help induce sleep, but they can also cause daytime sleepiness, cognitive impairment, dizziness, and dry mouth.
  • Trazadone, an antidepressant, is often prescribed for insomnia. Studies have found that Trazadone improves sleep at night, but does not affect sleepiness during the day, your overall thinking, or your brain function.

For detox purposes, Sound Recovery Solutions supports medication assisted treatment. Each client that comes to us is treated as a unique individual with special and specific needs for their treatment.For more information call 561-279-3860.

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