Opioid Withdrawal and What To Do
| TABLE 4. ACUTE OPIOID WITHDRAWAL SYMPTOMS | ||
|---|---|---|
| SIGN OR SYMPTOM | DESCRIPTION | NOTES |
| Pulse rate | Elevated pulse rate (above 100 bpm) may indicate withdrawal | May also be elevated if participant has been moving about, is feeling anxious, or has consumed caffeine or other stimulants. |
| Runny nose or tearing | Nasal stuffiness, nose running | Check if symptoms could be attributed to a cold or allergies before administering opioid antagonist. |
| Lacrimation | Moist and tearing eyes | Check if symptoms could be attributed to a cold or allergies before administering opioid antagonist. |
| Mydriasis | Pupils appear larger than normal for room light | Observe pupils before administering antagonist to assess for change. |
| Piloerection | Piloerection of skin, or hair standing up on arms | Ensure that ambient temperature is not the cause. |
| Diaphoresis | Reports of chills and flushing, observable beads of moisture or sweat | Assess for participant activity, room temperature, and other external factors before attributing sweating to opioid withdrawal. |
| Chills | Reports of chills | Assess for participant activity, room temperature, and other external factors prior to attributing sweating to opioid withdrawal. |
| Anxiety or irritability | Irritability or anxiousness, observable or self-reported | Some participants may have anxiety at baseline, particularly in relation to administration of opioid antagonists. Assess at baseline and question about external cause of anxiety. |
| Yawning | Observed yawning during observation period | |
| Tremulousness | Tremors or muscle twitching | |
| GI symptoms | Stomach cramps, nausea, loose stools, vomiting, or diarrhea | If participant has recently been detoxed from opioids there may be some residual symptoms such as GI discomfort. It is important to assess these symptoms at baseline and monitor for a worsening of these symptoms. |
