Addiction The Comedown, Crash, or Rebound Effect of Drugs How drug after-effects worsen addiction By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on June 02, 2024 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / Emily Roberts Table of Contents View All Table of Contents The Rebound Effect The Comedown The Crash Withdrawal Fatigue Energy Recovery How to Get Help What is the most important information I should know about drug rebound? The after-effects of prescription drugs and other substances can sometimes play a role in their misuse and contribute to the risk of addiction. Understanding these effects and knowing how to cope can help if you are struggling with misuse, withdrawal, or addiction. The effects of prescription and illegal can be short-lived, causing an individual to experience a rollercoaster of emotions if such drugs are misused. A rebound effect, a crash, and a comedown are drug after-effects that cause different symptoms. These effects play a role in the onset and maintenance of drug addiction. To avoid experiencing unpleasant effects, people sometimes continue using or taking more of a substance. This contributes to the cycle of addiction. Keep reading to learn more about what rebound, comedown, and crash are and the role that they play in addictions. Also, explore strategies that can help you cope and treatments that can help you recover from drug addiction. The Rebound Effect A rebound effect is what happens when the body tries to bring itself back into balance (a condition known as homeostasis) after a drug has been taken, by creating physical symptoms that are the opposite of those caused by the drug. Understanding the rebound effect explains why certain drugs, particularly those that have a quick and intense effect on the nervous system, are very addictive. One of the ironies of addiction is that the rebound effect causes the person taking the drug to experience the very same effects they were hoping to escape through drug use. This is especially true if the person wants to maintain the state such as wishing to stay awake or alert for longer than the effects of the stimulant or trying to sleep or relax for longer than the effects of the depressant, sedative, or tranquilizer. For example, when you take a sedative drug, which causes relaxation and drowsiness, a rebound effect of agitation will occur after the drug wears off, making you want to take more of the sedative drug in order to calm down. Taking more of a substance to counteract rebound effects can worsen the risk of developing an addiction, as people seek to recapture the effects they experienced after taking the drug. Pain is also intensified during a rebound from a painkiller, such as an opioid medication, a phenomenon known as opioid-induced hyperalgesia. The pain can be physical, emotional, or a combination of the two. Physical and emotional pain often go hand-in-hand, so it is easy to see how painkiller addiction develops. The Comedown The "comedown" is the feeling of the effects of a drug gradually wearing off, after a period of intoxication. It is often described as "coming down" from the drug's effects. The experience varies depending on the person, the amount of drug taken, as well as how long and how often the person has been using the drug. If the intoxication experience was too intense and made the person who took the drug feel uncomfortable, anxious, or delusional, the comedown can feel relatively mild, while for others, the comedown can be a disappointing sensation, signaling a return to reality and perhaps triggering further drug use. If you feel ill during a comedown, you may be having medical complications in reaction to the drug. If these persist, it is important to be evaluated for emotional or psychological symptoms, especially if they involve thoughts of hurting yourself or someone else, and psychotic symptoms, such as hearing voices. Make sure you tell them what you have taken, how much, and when. It is better to get early intervention than suffer greater complications later on. The Crash The "crash" is the intense exhaustion that people sometimes feel after using drugs, particularly those that are stimulating, such as cocaine, meth, and even high doses of caffeine. It involves helping the body recover not only from the toxicity and effects of the drugs, but also from any overexertion, lack of sleep, injuries, or other harms that potentially occurred during intoxication. This crash can last much longer than the original drug effects because the body needs longer to recover from the effects of the substance and other behaviors that may have affected the individual, such as lack of sleep. Highly addictive substances tend to create short-lived, intense effects that are followed by rapid-onset crashes. Withdrawal Fatigue Withdrawal is the physical and emotional experience that occurs when a drug is discontinued after a period of continuous or excessive use. If you stop taking a substance, you may experience withdrawal fatigue. Regardless of the substance taken, fatigue is a trademark symptom of withdrawal. Even if the substance was a relaxing substance, the inability to relax and sleep will lead to the person feeling more tired than usual. Research has shown that people withdrawing from alcohol have sleep disturbances, poor sleep quality, and do not function well during the day for a month after discontinuing drinking. They also experience considerable psychological distress during this time. Coping With Withdrawal Fatigue Withdrawal fatigue is exhausting, but people often try and keep going at their usual pace. This is not a good idea, as it will take longer to restore energy and return to normal activities. Fatigue is your body's way of getting you to rest and recuperate. Allow your body to recover by following these tips: Take a break. Take a break from your usual activities—don't go out socializing for a few days. Call in sick to work or school if you have to. Even if it is self-inflicted, you are not well enough to be up and about. Learn relaxation techniques. Practicing relaxation skills are very useful, and if you can, get enough sleep. Develop a relaxing bedtime routine. If you can't sleep, try and do restful activities during the night, and, unless you are fully asleep, get up, bathe, dress, and eat during the daytime. This will help reset your body clock, which may have been affected by you not sleeping and waking at the usual times while you were using drugs. Consume a healthy, well-balanced diet. Eating a balanced diet rich in fruit, vegetables, and protein, aids in the recovery process. If you don't have access to fresh food, talk to a pharmacist about the right amount of vitamin supplements. Vitamin C helps heal wounds, and vitamin B complex may help curb nicotine cravings. If you don't start to feel your energy return after a week or so of rest, see your doctor. Many people who use alcohol and drugs often have an underlying depressive disorder or other mood disorders. Sometimes, by getting proper treatment for depression, people find that their substance use problems improve and they can quit. However, some withdrawal symptoms can actually make mental illness symptoms like anxiety, depression, sex difficulties, sleep problems, and psychosis worse. These are known as substance-induced disorders. An addiction specialist is the best person to diagnose and treat your condition, but if you don't have access to a specialist, talk it over with another healthcare provider. Energy Recovery Everyone's recovery experience is different. The good news is that most people who stop using drugs and alcohol regain energy, sometimes in as little as a few weeks. Of course, how quickly you recover depends on many factors including: Your overall healthThe type of substance usedHow much and how often you were using the substanceLifestyle and emotional factors, such as whether you are living in a supportive environment, and whether you feel safe with the people around you Social support can play an important role in addiction recovery. If you are not living with or near people who support you, it will be more difficult to recover. If you are in an abusive relationship, it is unlikely you will feel alright until you get away from the abuser. No matter how much sleep you get, living with someone who hurts you emotionally or physically is exhausting. If this is the case for you, reach out for help. There are many resources available to help you and your children to make a fresh start. In the long term, nothing will be better for your energy than a drug-free, anxiety-free lifestyle. Your doctor or local police can help you if you are living with or feel controlled by someone you are in a relationship with. If you or a loved one are a victim of domestic violence, contact the National Domestic Violence Hotline at 1-800-799-7233 for confidential assistance from trained advocates. How to Get Help If you are experiencing rebound effects, coming down, or crashing due to using a substance, it is important to talk to your healthcare provider. Your doctor can evaluate your condition and recommend treatments that can help you manage your symptoms and recover from addiction. Each person's treatment plan varies depending on their symptoms and needs. Depending on the substance you have been taking, you may need to participate in medically-supervised detox. This process allows medical professionals to supervise the drug detoxification process to ensure your safety and minimize the risk of severe or life-threatening symptoms. Other treatments for addiction often focus on: Psychotherapy Types of therapy that your doctor might recommend include cognitive-behavioral therapy (CBT), contingency management, and motivational enhancement therapy. Such treatments may be provided on either an outpatient or inpatient basis, depending on your needs. Medication Your doctor may also prescribe medications that can help alleviate symptoms of withdrawal and prevent relapse. The type of medication your doctor prescribes will depend on the substance you have been taking and the type of symptoms you have been experiencing. Mutual Support Groups Support groups such as 12-step self-help programs can be a great way to get encouragement, information, and resources that can help you on your journey to recovery. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Understanding Withdrawal and Its Effects 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lerner A, Klein M. Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development. Brain Commun. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025 Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A review of alprazolam use, misuse, and withdrawal. J Addict Med. 2018;12(1):4-10. doi:10.1097/ADM.0000000000000350 Wilson SH, Hellman KM, James D, Adler AC, Chandrakantan A. Mechanisms, diagnosis, prevention and management of perioperative opioid-induced hyperalgesia. Pain Manag. 2021;11(4):405-417. doi:10.2217/pmt-2020-0105 McKetin R, Copeland J, Norberg MM, Bruno R, Hides L, Khawar L. The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence. Drug Alcohol Depend. 2014;139:26-32. doi:10.1016/j.drugalcdep.2014.02.697 Substance Abuse and Mental Health Services Administration (US). 4 Physical Detoxification Services for Withdrawal from Specific Substances. Parrott AC. Why all stimulant drugs are damaging to recreational users: An empirical overview and psychobiological explanation. Hum Psychopharmacol. 2015;30(4):213-24. doi:10.1002/hup.2468 Angarita GA, Emadi N, Hodges S, Morgan PT. Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: A comprehensive review. Addict Sci Clin Pract. 2016;11(1):9. doi:10.1186/s13722-016-0056-7 Gómez-coronado N, Sethi R, Bortolasci CC, Arancini L, Berk M, Dodd S. A review of the neurobiological underpinning of comorbid substance use and mood disorders. J Affect Disord. 2018;241:388-401. doi:10.1016/j.jad.2018.08.041 Johnson K, Stewart S, Rosenfield D, Steeves D, Zvolensky M. Prospective evaluation of the effects of anxiety sensitivity and state anxiety in predicting acute nicotine withdrawal symptoms during smoking cessation. Psychol Addict Behav.2012;26(2):289-297. Lookatch SJ, Wimberly AS, McKay JR. Effects of social support and 12-step involvement on recovery among people in continuing care for cocaine dependence. Subst Use Misuse. 2019;54(13):2144-2155. doi:10.1080/10826084.2019.1638406 Additional Reading American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington DC:2013. By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit