When Sam was going through withdrawal of demon blood he became so desperate to get his fixed, that he sink his teeth into a demon right in front of Dean. The led to Dean and Bobby tricking Sam into going in the panic room in Bobby’s basement and locking him inside to force him to detox.

Which meant he was also being forced to go through all the effect of withdrawal. He sits crosslegged on the floor of the room and looks around, sweat covering his face.

His vision blurs in and out of focus until he spots the pitcher of water and tries to get it; having to brace himself on the cot to get off the floor.