Comedowns
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Comedowns (also referred to as crashes or hangovers) is the deterioration of one's mental and physical state that occurs during the offset of a psychoactive substance, most commonly stimulants but can occur with most drug classes such as opiates or alcohol. The opposite of a comedown would be an afterglow, more commonly experienced after dissociatives or psychedelics. The comedown is distinct from withdrawal because it can happen to nontolerant users; this is unlike withdrawal which is more likely to occur in users who are dependent on the drug.
Stimulant comedowns
Stimulants are the most likely class of drugs to cause a noticeable comedown, with the dysphoria appearing very abruptly after the peak and then gradually turning into general physical fatigue as the drug is eliminated from the bloodstream.
Different routes of administration and redosing will affect the intensity of the comedown drastically. For example, consuming the drug intranasally and redosing will produce a much harsher comedown than using a single dose orally (this is attributed to faster absorption and excretion rates).
Signs and symptoms
The effects which occur during the offset of a stimulant experience generally feel negative and uncomfortable in comparison to the effects which occurred during its peak. This generally occurs because of neurotransmitter depletion. Its effects commonly include:
- Anxiety
- Appetite suppression
- Cognitive fatigue
- Delusion
- Depression
- Feelings of impending doom - This can be especially present over periods of sustained stimulant use.
- Irritability
- Motivation suppression
- Physical fatigue
- Restless leg syndrome
- Sleep paralysis
- Stimulant psychosis - This is especially present after ceasing use abruptly after multiple days of use.
- Thought deceleration
- Wakefulness
Treatment options
- Tyrosine
- 5-HTP (only if the stimulant was serontonergic)
- Hydration and food
- Depressants - This may help with anxiety, irritability, wakefulness and restless legs syndrome. However, the use may lead to addiction and other health risks.
Psychedelic comedowns
This can occur with any psychedelic substance, but especially with long lasting and stimulating psychedelics like DOC, DOB, and 2C-P.
Signs and symptoms
Treatment options
- Hydration and food - Staying hydrated during the trip and while coming down is of the upmost importance.
- Depressants - Some depressants, such as benzodiazepines, can be used to sedate the user and put them to sleep before the comedown begins. However, benzodiazepines do not stop the psychedelic visuals; they only calm and sedate the individual. Antipsychotics will cease any hallucinations or visuals.
- N-Acetylcysteine