Opioid withdrawal

Revision as of 02:50, 5 January 2012 by Jswartz (talk | contribs)

Background

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

Clinical Features

  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

Treatment

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

Source

  • Tintinalli