ADVISORY

Substance Abuse Treatment

July 2010
Volume 9
Issue 1

News for the Treatment Field

Protracted Withdrawal
Most clients in treatment for substance use disorders
(SUDs) do not immediately feel better after stopping
their substance use. In a pattern unique to each client,
symptoms related to substance abuse may be felt for
weeks, months, and sometimes years. Clients may be
affected by less intense versions of the acute signs
and symptoms of withdrawal as well as by other
conditions such as impaired ability to check impulses,
negative emotional states, sleep disturbances, and
cravings. These symptoms may lead clients to seek
relief by returning to substance use, feeding into the
pattern of repeated relapse and return to treatment.1, 2
SUD treatment providers can help clients avoid
this cycle by helping them recognize and manage
symptoms.
Some clients in recovery also experience symptoms
from co-occurring substance use and mental
disorders. The SUD treatment providers challenge is
to determine which of a clients abstinence symptoms
are substance-use related and will resolve over time
and which indicate a possible co-occurring disorder
(COD) that calls for a thorough assessment by a
mental health provider and concurrent care. Treatment
Improvement Protocol (TIP) 42: Substance Abuse
Treatment for Persons With Co-Occurring Disorders
provides more information on CODs and their
treatment.3
This Advisory differentiates acute withdrawal from
protracted withdrawal, provides an overview of
protracted withdrawal signs and symptoms, and offers
suggestions on how to help clients manage protracted
withdrawal in recovery.

What is acute withdrawal?

Acute withdrawal is usually referred to simply as
withdrawal. The American Society of Addiction
Medicine defines withdrawal as the onset of a
predictable constellation of signs and symptoms
following the abrupt discontinuation of, or rapid
decrease in, dosage of a psychoactive substance.4
Such signs and symptoms are generally the opposite
of the intoxication effects of the particular substance.5
For example, pupils constrict during opioid
intoxication and dilate during acute withdrawal.
These signs and symptoms begin within hours or days
after last use of the substance and gradually resolve.
The length of time symptoms last depends on the
particular substance used. Exhibit 1 lists approximate
timeframes for acute withdrawal from several
substances.

Exhibit 1. Acute Withdrawal Timeframes

for Specific Substances
Acute Withdrawal
Timeframe

Substance
Alcohol6, 7
Benzodiazepines

57 days
8, 9

14 weeks; 35 weeks
with tapering (i.e., reducing
dosage gradually)

Cannabis10

5 days

Nicotine

24 weeks

11

Opioids12

410 days (methadone

withdrawal may last 1421
days)

Stimulants (e.g.,
amphetamines,
methamphetamine,
cocaine)13

12 weeks

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
www.samhsa.gov

continued on reverse...

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What is protracted withdrawal?

Protracted withdrawal, strictly defined, is the presence of
substance-specific signs and symptoms common to acute
withdrawal but persisting beyond the generally expected
acute withdrawal timeframes noted in Exhibit 1. A
broader definition of protracted withdrawal, and the one
used in this Advisory, includes the experiencing of the
above symptoms and of non-substance-specific signs and
symptoms that persist, evolve, or appear well past the
expected timeframe for acute withdrawal. Exhibit 2 lists
other terms sometimes used for protracted withdrawal.

Exhibit 2. Synonyms for Protracted

Withdrawal

Chronic withdrawal
Extended withdrawal
Late withdrawal
Long-term withdrawal
Persistent postuse symptoms
Postacute withdrawal syndrome
Postuse syndrome
Protracted abstinence
Sobriety-based symptoms
Subacute withdrawal

Despite clinical observation and clients reports of

symptoms experienced past the acute withdrawal stage,
the research on protracted withdrawal (particularly
for substances other than alcohol) is limited, and no
consensus on the term or definition exists. These reasons
have precluded the Diagnostic and Statistical Manual of
Mental Disorders from including a protracted withdrawal
diagnosis for any psychoactive substance.6 For these
reasons also, this Advisory does not provide timeframes
for protracted withdrawal as is done for acute withdrawal
in Exhibit 1.

How do protracted withdrawal

symptoms develop?
Chronic substance use causes molecular, cellular, and
neurocircuitry changes to the brain that affect emotions
and behavior and that persist after acute withdrawal has
ended.14, 15, 16, 17 Adaptive changes in the central nervous
system may lead to affective changes that persist for
many weeks or longer beyond acute withdrawal.18 For
example, repeated use of a substance causes the brain
to respond more readily to its effects but less readily to
naturally rewarding activities such as listening to music.
This state, in which a persons ability to experience
pleasure is decreased, is called anhedonia. Pozzi and
colleagues examined anhedonia in individuals who had
been abstinent from alcohol, opioids, and/or other drugs
for a period and who had no identified CODs.19 Their
study examined whether anhedonia may be linked to
psychosocial factors in the lives of people recovering
from SUDs. They conclude that anhedonia appeared to be
a symptom of protracted withdrawal that was unrelated
to other clinical and psychosocial features. Martinotti
and colleagues found that signs and symptoms, including
anhedonia, lasted the duration of a year-long study of
people recovering from alcohol use disorders.20
A variety of other symptoms have been attributed
to protracted withdrawal, including anxiety, sleep
difficulties, problems with short-term memory, persistent
fatigue, difficulty concentrating and making decisions,
alcohol or drug cravings, and impaired executive control
(e.g., impulse control, solving problems).

Are protracted withdrawal

symptoms the same for all
substances?
No. They are similar but not identical. Each psychoactive
substance class has different effects on the brain.
Protracted withdrawal from alcohol has been well
documented. Common protracted withdrawal symptoms
include anxiety, hostility, irritability, depression, mood

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instability, fatigue, insomnia, difficulties concentrating

and thinking, reduced interest in sex, and unexplained
physical complaints especially of pain. Anecdotal
literature and case studies going back several decades
suggest that signs and symptoms may last 2 years or
longer after the last use of alcohol. A review of seven
sleep studies using polysomnograph recordings of
the brain while people slept found evidence that sleep
abnormalities can persist for 1 to 3 years after stopping
alcohol consumption.21 These abnormalities include
difficulty falling asleep, decreased total sleep time, and
sleep apnea.
Research on drug-specific protracted withdrawal signs
and symptoms is scarce but indicates the following:

Opioids. Symptoms such as anxiety, depression,

and sleep disturbances can last for weeks or months
following withdrawal from opioids.22 Other possible
symptoms include fatigue, dysphoria (i.e., feeling
down or emotionally blunted), and irritability.12
A small National Institutes of Health study found
that subjects who had been abstinent from opioids
for a prolonged period showed decreased ability to
focus on a task compared with subjects who had
never used opioids.23 People in recovery from heroin
dependence also show deficits in executive control
functions that may persist for months beyond the
period of acute withdrawal. 24
Methamphetamine. A 2007 review noted that
studies have shown that deficits in executive control
functions resulting from amphetamine use also
persist well into recovery from methamphetamine
dependence.25
Cocaine. Fox and colleagues examined emotional
regulation issues and problems with impulse
control in newly abstinent individuals dependent
on cocaine.26 Significant improvement in several
aspects of emotional regulation (e.g., understanding
and managing emotions, ability to develop
emotional coping strategies) was seen after 4 weeks
of abstinence. However, impulse control had not
improved after 4 weeks of abstinence.

Marijuana. A review of 19 studies of marijuana

withdrawal found that sleep difficulties and strange
dreams persisted at least 45 days into abstinence (the
longest duration of the studies).27
Benzodiazepines. Benzodiazepine protracted
withdrawal may be difficult to diagnose because of
difficulty distinguishing it from symptom rebound
or symptom reemergence (Exhibit 3).28 Protracted
withdrawal symptoms typically wax and wane in
intensity and are new to the client (i.e., they do
not indicate symptom reemergence). Clients also
may have no symptoms for a time after stopping
benzodiazepine use and then become extremely
anxious. Psychological symptoms can mimic
disorders such as agitated depression; generalized
anxiety, panic, or obsessive-compulsive disorders;
and schizophrenia. Fluctuating protracted withdrawal
symptoms may last for months but gradually subside
with prolonged abstinence.

Exhibit 3. Symptom Rebound and

Symptom Reemergence
Symptom rebound, the most common
aftereffect of prolonged benzodiazepine
use, is the intensified return of acute
withdrawal signs and symptoms. These
acute symptoms are typically opposite the
effects of the drug (e.g., anxiety, insomnia,
restlessness) and tend to abate in a few
weeks.29
Symptom reemergence is the return of
symptoms (e.g., anxiety, muscle tension,
insomnia) at the same level as those
experienced before benzodiazepines were
prescribed or taken. These symptoms
do not abate with time. Because these
symptoms were present before the
substance use began, they suggest the
presence of an underlying pathology
needing treatment.30

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Do all clients experience

protracted withdrawal?
No. Some clients experience no symptoms after the
acute withdrawal stage, whereas others have lingering
symptoms. Still others experience an initial clearing of
symptoms for the first month or two of abstinence and
then develop unpleasant symptoms again. The intensity
of symptoms also differs among clients.

How can providers help clients

through protracted withdrawal?

Clients affected by anhedonia and other symptoms

of protracted withdrawal may want to alleviate those
symptoms by returning to substance use at a time
when they may have a weakened ability to resist such
impulses. Treatment providers can improve their
clients chances for long-term recovery by educating
clients about protracted withdrawal, offering support
and understanding, monitoring them regularly, and
intervening early with clients who seem headed for
relapse:

Educate clients about protracted withdrawal

and help them develop realistic attitudes toward
recovery. Remind clients that recovery is a process.
Help clients understand that it is normal to feel not
fully recovered within the first weeks and months
of abstinence. Tell them about possible protracted
withdrawal symptoms (Exhibit 4) and reassure them
that these symptoms will not last forever and can be
managed. Advise clients on how to reduce or cope
with symptoms and encourage them to focus on
incremental improvements. Tell clients it takes time
to undo the damage from substance use but in many
cases, with long-term abstinence, substance-induced
brain changes reverse.
Celebrate each accomplishment (e.g.,

learning a new coping skill) and help clients not

become discouraged if symptoms recur. Repeat

encouragements at each meeting, especially with

Exhibit 4. Possible Symptoms of

Protracted Withdrawal

Anxiety
Sleep difficulties
Problems with short-term memory
Persistent fatigue
Difficulty concentrating and making
decisions
Alcohol or drug cravings
Impaired executive control
Anhedonia
Difficulty focusing on tasks
Dysphoria or depression
Irritability
Unexplained physical complaints
Reduced interest in sex

clients affected by memory and concentration

impairments.

Assess for CODs. The symptoms of protracted

withdrawal can be similar to those of traumatic brain
injury (TBI) and CODs. Carefully assess and reassess
clients as recovery proceeds, including for depression
and suicidal tendencies. TIP 42,3 TIP 48: Managing
Depressive Symptoms in Substance Abuse Clients
During Early Recovery,31 and TIP 50: Addressing
Suicidal Thoughts and Behaviors in Substance
Abuse Treatment32 provide more information on
CODs and suicide. An Advisory in development will
provide information on assessing and addressing
TBI in recovery.33 Appropriate treatment of a COD
positively affects the course of treatment.34
Ask about sleep problems. Make a differential
diagnosis to determine whether a clients sleep
problems likely stem from protracted withdrawal or
are the result of other causes. Such causes include
poor sleep habits retained from a substance-using
lifestyle, CODs, relapse to substance use, stress, or

Protracted Withdrawal

ADVISORY
Substance Abuse Treatment

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side effects of medication (including medication to

treat SUDs). Educate clients about good sleep habits:
adopting a regular sleep routine (going to bed and
getting up at the same times), exercising early in the
day, minimizing caffeine intake, eating well, and
avoiding late afternoon naps. Use pharmacological
treatments with caution to avoid use problems.
The Substance Abuse and Mental Health Services
Administrations (SAMHSAs) Center for Substance
Abuse Treatment (CSAT) is developing a Substance
Abuse in Brief Fact Sheet on sleep problems that will
provide more information.35
Advise clients to be active. Encourage clients to
engage in physical and mental exercises, which
improve sleep, promote positive emotional states,
reduce stress and nervousness, help clients avoid
triggers, and distract clients attention from
symptoms. Assist clients in adopting habits that help
them cope with memory and thinking problems (e.g.,
making to-do lists, establishing daily routines).
Advise clients to be patient. Clients in early
recovery may try to make up for lost time by
overbooking and generally trying to do too much,
increasing their overall stress levels and possibly
exacerbating symptoms. Tell clients that they are
doing enough by focusing on their recovery and
regaining their health.
Prescribe medications as needed to control
symptoms past the acute withdrawal stage.
Inform clients recovering from alcohol addiction
that treatment medications, such as acamprosate,
might relieve some protracted withdrawal symptoms.
Although acamprosates mechanism of action is
not well understood, it may reduce uncomfortable
symptoms such as anxiety and sleep disturbances
that clients feel after they have stopped drinking.
SAMHSAs CSAT Advisory on acamprosate
provides more information.36 Consider methadone
or buprenorphine replacement treatment for clients
who find that protracted opioid withdrawal symptoms

are too powerful and for whom the risk of relapse is

high.37
Encourage clients to join mutual support groups.
Tell clients that participation in mutual support
groups such as Alcoholics Anonymous or Women in
Sobriety is associated with long periods of recovery.
Make clients aware of population-specific support
groups (e.g., adolescents- or women-only groups).
Direct clients in medicated-assisted treatment to
support groups that accept the use of prescribed
medications for substance abuse treatment. Tell
clients that they may need to visit several groups over
several weeks to find groups with which they feel
comfortable. SAMHSAs CSAT Substance Abuse in
Brief Fact Sheet on mutual support groups provides
more information.38
Include interventions that help clients strengthen
executive control functions. Provide interventions
such as cognitivebehavioral therapy to help clients
manage problems with impulse control, solve
problems, and make decisions.39
Monitor clients for symptoms during continuing
care. Provide clients with opportunities to obtain
professional guidance on such issues as lapses and
relapses, stress, triggers, and activities to maintain
abstinence. Monitoring can be through periodic office
visits or by telephone or email. Arrange for transition
to a case manager as needed.40

SAMHSA Resources
Several publications are available free of charge from
SAMHSAs Health Information Network. The resources
listed on page 6 can be ordered at http://www.samhsa.
gov/shin. Or, please call 1-877-SAMHSA-7 (1-877-726
4727). The publications also can be downloaded from the
Knowledge Application Program Web site at
http://www.kap.samhsa.gov.

July 2010, Volume 9, Issue 1

ADVISORY
Substance Abuse Treatment

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Resources for professionals

Substance Abuse Treatment Advisory, Acamprosate:

A New Medication for Alcohol Use Disorders. (2005).

HHS Publication No. (SMA) 05-4114.

TIP 42: Substance Abuse Treatment for Persons With

Co-Occurring Disorders. (2005). HHS Publication No.
(SMA) 05-3992.
TIP 43: Medication-Assisted Treatment for Opioid
Addiction in Opioid Treatment Programs. (2005).
HHS Publication No. (SMA) 05-4048.
TIP 45: Detoxification and Substance Abuse Treatment.
(2006). HHS Publication No. (SMA) 06-4131.
TIP 48: Managing Depressive Symptoms in Substance

Abuse Clients During Early Recovery. (2008).

HHS Publication No. (SMA) 08-4353.

TIP 50: Addressing Suicidal Thoughts and Behaviors in

Substance Abuse Treatment. (2009). HHS Publication

No. (SMA) 09-4381.

Resources for clients

The Facts About Buprenorphine for Treatment of Opioid
Addiction. (2009). HHS Publication No. (SMA) 09-4442.
The Facts About Naltrexone for Treatment of Opioid
Addiction. (2009). HHS Publication No. (SMA) 09-4444.
Medication-Assisted Treatment for Opioid Addiction:
Facts for Families and Friends. (2009). HHS Publication
No. (SMA) 09-4443.
What Is Substance Abuse Treatment? A Booklet for
Families. (2004). HHS Publication No. (SMA) 08-4126.

Notes
Scott, C., Foss, M., & Dennis, M. (2005). Pathways in the
relapsetreatmentrecovery cycle over 3 years. Journal of
Substance Abuse Treatment, 28, S63S72.
1

Office of Applied Studies. (2002). The DASIS Report: New and

repeat admissions to substance abuse treatment. Rockville, MD:
Substance Abuse and Mental Health Services Administration.
2

Center for Substance Abuse Treatment. (2005). Substance

abuse treatment for persons with co-occurring disorders.
Treatment Improvement Protocol 42. HHS Publication No.
(SMA) 05-3992. Rockville, MD: Substance Abuse and Mental
Health Services Administration.

Ries, R. K., Miller, S. C., Fiellin, D. A., & Saitz, R. (Eds.).

(2009). Appendix 1: ASAM addiction terminology. In Principles
of addiction medicine (4th ed.). Chevy Chase, MD: American
Society of Addiction Medicine.

Wright, T. M., Culver, J. S., & Myrick, H. (2009). Management

of intoxication and withdrawal: General principles. In R. K.
Ries, S. C. Miller, D. A. Fiellin, & R. Saitz (Eds.), Principles of
addiction medicine (4th ed., pp. 552558). Chevy Chase, MD:
American Society of Addiction Medicine.

American Psychiatric Association. (2000). Diagnostic and

statistical manual of mental disorders (4th ed., text revision).
Washington, DC: Author.

Center for Substance Abuse Treatment. (2006). Detoxification

and substance abuse treatment. Treatment Improvement Protocol
45. HHS Publication No. (SMA) 06-4131. Rockville, MD:
Substance Abuse and Mental Health Services Administration.

Dickinson, W. E., Mayo-Smith, M. F., & Eickelberg, S. J.

(2003). Management of sedative-hypnotic intoxication and
withdrawal. In A. W. Graham, T. K. Schultz, M. F. Mayo-Smith,
R. K. Ries, & B. B. Wilford (Eds.), Principles of addiction
medicine (3rd ed., pp. 633639). Chevy Chase, MD: American
Society of Addiction Medicine.

Juergens, S. T., & Cowley, D. S. (2003). The pharmacology of

benzodiazepines and other sedative-hypnotics. In A. W. Graham,
T. K. Schultz, M. F. Mayo-Smith, R. K. Ries, & B. B. Wilford
(Eds.), Principles of addiction medicine (3rd ed., pp. 119138).
Chevy Chase, MD: American Society of Addiction Medicine.

Welch, S. P., & Martin, B. R. (2003). The pharmacology of

marijuana. In A. W. Graham, T. K. Schultz, M. F. Mayo-Smith,
R. K. Ries, & B. B. Wilford (Eds.), Principles of addiction
medicine (3rd ed., pp. 249270). Chevy Chase, MD: American
Society of Addiction Medicine.
10

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ADVISORY
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Hughes, J. R. (2007). Effects of abstinence from tobacco:

Valid symptoms and time course. Nicotine & Tobacco Research,
9(1), 315327.

11

Collins, E. D., & Kleber, H. D. (2004). Opioids:

Detoxification. In M. Galanter & H. D. Kleber (Eds.), Textbook
of substance abuse treatment (3rd ed., 265289). Washington,
DC: American Psychiatric Publishing.
12

Wilkins, J. N., Danovitch, I., & Gorelick, D. A. (2009).

Management of stimulant, hallucinogen, marijuana,
phencyclidine, and club drug intoxication and withdrawal. In R.
K. Ries, S. C. Miller, D. A. Fiellin, & R. Saitz (Eds.), Principles
of addiction medicine (4th ed., 607628). Chevy Chase, MD:
American Society of Addiction Medicine.
13

Aston-Jones, G., & Harris, G. C. (2004). Brain substrates

for increased drug seeking during protracted withdrawal.
Neuropharmacology, 47(Suppl 1), 167179.
14

Goldstein, R. Z., & Volkow, N. D. (2002). Drug addiction and

its underlying neurobiological basis: Neuroimaging evidence
for the involvement of the frontal cortex. American Journal of
Psychiatry, 159(101), 16421652.
15

Koob, G. F. (2008). Neurobiological substrates for the dark

side of compulsivity in addiction. Neuropharmacology, 56(Suppl
1), 1831.
16

Koob, G. F., & Le Moal, M. (2001). Drug addiction,

dysregulation of reward, and allostasis. Neuropsychopharmacology, 24(20), 97129.
17

Weiss, F., Ciccocioppo, R., Parsons, L. H., Katner, S., Liu, X.,
Zorrilla, E. P., et al. (2001). Compulsive drug-seeking behavior
and relapse: Neuroadaptation, stress, and conditioning factors.
Annals of the New York Academy of Sciences, 937, 126.
18

Pozzi, G., Martinotti, G., Reina, D., Dario, T., Frustaci, A.,
Janiri, L., et al. (2008). The assessment of post-detoxification
anhedonia: Influence of clinical and psychosocial variables.
Substance Use & Misuse, 43(5), 722732.
19

Martinotti, G., Di Nicola, M., Reina, D., Andreoli, S., Foc,

F., Cunniff, A., et al. (2008). Alcohol protracted withdrawal
syndrome: The role of anhedonia. Substance Use & Misuse,
43(3&4), 271284.
20

Brower, K. J. (2001). Alcohols effects on sleep in alcoholics.

Alcohol Research & Health, 25(2), 110125.
21

Satel, S. L., Kosten, T. R., Schuckit, M. A., & Fischman, M.

W. (1993). Should protracted withdrawal from drugs be included
in DSM-IV? American Journal of Psychiatry, 150(5), 695704.
22

Prosser, J., London, E. D., & Galynkera, I. I. (2009).

Sustained attention in patients receiving and abstinent following
methadone maintenance treatment for opiate dependence:
Performance and neuroimaging results. Drug and Alcohol
Dependence, 104, 228240.
23

Li-ping, F., Guo-hua, B., Zhi-tong, Z., Yan, W., En-mao, Y.,
Lin, M., et al. (2008). Impaired response inhibition function
in abstinent heroin dependents: An fMRI study. Neuroscience
Letters, 438, 322326.
24

Baicy, K., & London, E. D. (2007). Corticolimbic

dysregulation and chronic methamphetamine abuse. Addiction,
102(Suppl 1), 515.
25

Fox, H. C., Axelrod, S. R., Paliwal, P. J., Sleeper, J., & Sinha,
R. (2007). Difficulties in emotion regulation and impulse control
during cocaine abstinence. Drug and Alcohol Dependence, 89,
298301.
26

Budney, A. J., Hughes, J. R., Moore, B. A., & Vandrey, R.

G. (2004). Review of the validity and significance of cannabis
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27

Smith, D. E., & Wesson, D. R. (2004). Benzodiazepines and

other sedative-hypnotics. In M. Galanter & H. D. Kleber (Eds.),
Textbook of substance abuse treatment (3rd ed., pp. 239242).
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28

Salzman, C. (1991). The APA task force report on

benzodiazepine dependence, toxicity, and abuse. American
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29

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30

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Center for Substance Abuse Treatment. (2008). Managing

depressive symptoms in substance abuse clients during early
recovery. Treatment Improvement Protocol 48. HHS Publication
No. (SMA) 08-4353. Rockville, MD: Substance Abuse and
Mental Health Services Administration.

31

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32

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33

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34

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sleep problems of people in recovery from substance use
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35

Center for Substance Abuse Treatment. (2005). Acamprosate:

A new medication for alcohol use disorders. Substance Abuse
Treatment Advisory, 4(1).
36

Center for Substance Abuse Treatment. (2005). Medicationassisted treatment for opioid addiction in opioid treatment
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37

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38

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39

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40

Substance Abuse Treatment Advisory

This Substance Abuse Treatment Advisory was written and produced under contract numbers 270-04-7049 and 270-09-0307
by the Knowledge Application Program (KAP), a Joint Venture of JBS International, Inc., and The CDM Group, Inc., for the
Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA),
U.S. Department of Health and Human Services (HHS).
Disclaimer: The views, opinions, and content expressed herein do not necessarily reflect the views or policies of CSAT,
SAMHSA, or HHS. No official support of or endorsement by CSAT, SAMHSA, or HHS for these opinions or for particular
instruments, software, or resources is intended or should be inferred.
Public Domain Notice: All materials appearing in this document except those taken directly from copyrighted sources are in
the public domain and may be reproduced or copied without permission from SAMHSA/CSAT or the authors. Citation of the
source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written
authorization of the Office of Communications, SAMHSA, HHS.
Electronic Access and Copies of Publication: This publication may be downloaded or ordered from http://www.samhsa.
gov/shin. Or, please call SAMHSAs Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727). The document
can be downloaded from the KAP Web site at
http://www.kap.samhsa.gov.
Recommended Citation: Center for Substance Abuse
Treatment. (2010). Protracted Withdrawal. Substance Abuse
Treatment Advisory, Volume 9, Issue 1.

Substance Abuse Treatment Advisory

Protracted Withdrawal

HHS Publication No. (SMA) 10-4554

Printed 2010