Opioid withdrawal

Revision as of 15:44, 12 March 2015 by Rossdonaldson1 (talk | contribs)

Background

  • Uncomfortable but not life-threatening
    • only life-threatening in neonates
  • Onset is 6-12hr after last heroin use, within 30hr after last methadone use

Clinical Presentation

  1. Onset: within hours of cessation
  2. Peak effects: 36-72hr
    1. Anxiety
    2. Craving
    3. Yawning
    4. Rhinorrhea
    5. Diaphoresis
  3. Onset: 12hr after cessation
  4. Peak effects: 72hr
    1. Tremor
    2. Piloerection
    3. Mydriasis
    4. Irritability
  5. Onset: 24-36hr after cessation
  6. Peak effects: 72hr
    1. Muscle spasm
    2. Abd pain
    3. N/V/D

Workup

  • Normally a clinical diagnosis

Differential Diagnosis

Treatment

  1. Clonidine
    • 5mcg/kg PO (as long as SBP >90)
  2. Hydroxyzine
    • 50-100mg PO QID x5d
  3. Antiemetics
  4. Antidiarrheals
  5. NSAIDS
  6. PO/IV hydration

See Also

Source

  • Tintinalli
Retrieved from "https://www.wikem.org/w/index.php?title=Opioid_withdrawal&oldid=33663"