Withdrawal symptoms for caffeine and heroin: A simple comparison

There are two columns below. One is the list of commonly reported withdrawal symptoms from caffeine. The other is a list of commonly reported withdrawal symptoms for heroin. See if you can guess which is which:

Abdominal cramping Abdominal cramping
Agitation Agitation
Anxiety Anxiety
Constipation Constipation
Diarrhea Diarrhea
Difficulty concentrating Difficulty concentrating
Dysphoria Dysphoria
Headaches Headaches
Hot and Cold Flashes Hot and Cold Flashes
Muscle aches Muscle Aches
Nausea and vomiting Nausea and vomiting
Runny nose Runny nose
Tremors Tremors
Yawning Yawning

Yup – you guessed it. The first column is heroin withdrawal – insomnia is not commonly reported with caffeine withdrawal. Otherwise, the symptoms of caffeine and heroin withdrawal are pretty much the same.

Not sure about this? Here are a few sources on caffeine withdrawal. Obviously, not everyone suffers extreme withdrawal symptoms when they quit coffee, just as most people who try heroin don’t get addicted and thus suffer no withdrawal. But for those who are hooked, the path off of both drugs looks about the same.

Of course, caffeine mildly promotes pro-social behavior while heroin detracts from it. These drugs differ dramatically in ease of access and social acceptability, risk of use, effects on driving, whether or not you want the user left alone in your house, etc.

As such, we tend to downplay the effects of caffeine withdrawal, but have great fun with the supposedly overwhelming effects of heroin withdrawal.

But on the things you can measure, and that are less socially conditioned – the actual signs of physical withdrawal – the similarities are striking. It is almost as if the major symptoms of withdrawal are determined less by the chemical structure of the substance missed, and more by the body’s reaction to missing something to which it is addicted. An analogy would be anaphylaxis, which presents the same signs and symptoms regardless of whether it was triggered by peanuts or penicillin or latex.

One other thing: What about the urban myth that heroin withdrawal symptoms are so severe that they can cause death? There is no medical evidence of this. Sources that make this claim tend to be selling something, like anesthesia-aided rapid opioid detox (AAROD) services. AAROD, unlike heroin withdrawal, is dangerous and potentially deadly.

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