Opioid withdrawal: Difference between revisions
| Line 3: | Line 3: | ||
*Symptoms are usually uncomfortable but not life-threatening | *Symptoms are usually uncomfortable but not life-threatening | ||
**Catecholamine surge during withdrawal may cause a level of hemodynamic instability that may not be tolerated by patients with co-morbid conditions | **Catecholamine surge during withdrawal may cause a level of hemodynamic instability that may not be tolerated by patients with co-morbid conditions | ||
** | **life-threatening in neonates | ||
*Onset is 6-12hr after last heroin use, within 30hr after last methadone use | *Onset is 6-12hr after last heroin use, within 30hr after last methadone use | ||
Revision as of 17:16, 8 March 2016
Background
- Withdrawal can be precipitated with administration of antagonist (e.g. naloxone) or partial agonist (e.g. buprenorphine).
- Symptoms are usually uncomfortable but not life-threatening
- Catecholamine surge during withdrawal may cause a level of hemodynamic instability that may not be tolerated by patients with co-morbid conditions
- life-threatening in neonates
- Onset is 6-12hr after last heroin use, within 30hr after last methadone use
Clinical Presentation
- Onset: within hours of cessation
Early symptoms
- Agitation
- Anxiety
- Muscle aches
- Increased tearing
- Insomnia
- Runny nose
- Sweating
- Yawning
- Skin-Crawling
Late symptoms
Workup
- Normally a clinical diagnosis
- Consider a urine tox
Differential Diagnosis
Treatment
- Clonidine
- 5mcg/kg PO (as long as SBP >90)
- Hydroxyzine
- 50-100mg PO QID x5d
- Antiemetics
- Antidiarrheals
- NSAIDS
- PO/IV hydration
See Also
Source
- Tintinalli