Opioid withdrawal
Background
- Uncomfortable but not life-threatening
- Onset is 6-12hr after last heroin use, within 30hr after last methadone use
Clinical Features
- Onset: within hours of cessation
- Peak effects: 36-72hr
- Anxiety
- Craving
- Yawning
- Rhinorrhea
- Diaphoresis
- Onset: 12hr after cessation
- Peak effects: 72hr
- Tremor
- Piloerection
- Mydriasis
- Irritability
- Onset: 24-36hr after cessation
- Peak effects: 72hr
- Muscle spasm
- Abd pain
- N/V/D
Treatment
- Clonidine
- 5mcg/kg PO (as long as SBP >90)
- Hydroxyzine
- 50-100mg PO QID x5d
- Antiemetics
- Antidiarrheals
Source
- Tintinalli
