Opiate withdrawal
Background
- Onset depends on drug used, usually ~12 hours after last heroin, ~30 hours after last methadone
- extremely unpleasant, but not life-threatening
Clinical Features
- tachycardia, mydriasis, piloerection, diaphoresis
- restlessness, insomnia, anxiety
- rhinorrhea, yawning
- nausea/vomiting, abdominal cramping, diarrhea, muscle cramps
Differential Diagnosis
Evaluation
Management
- symptomatic/supportive care
- antiemetics
- analgesia
- clonidine
- dicyclomine
- methadone, buprenorphine