Opioid withdrawal resident survival guide
| Resident Survival Guide |
|---|
| Introduction |
| Team |
| Guide |
| Page Template |
| Examine the Patient Template |
| Navigation Bar Template |
| Checklist |
| Topics |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]
Definition
This section provides a short and straight to the point definition of the disease or symptom in one sentence.
| Opioid | Peak withdrawal symptoms | Duration of symptoms |
|---|---|---|
| Heroin | 36-72 hours | 7-10 days |
| Methadone | 72-96 hours | 14 days |
| Buprenorphine | 36-72 hours | 7 days |
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Management
Shown below is an algorithm summarizing the approach to [[Opioid withdrawal]].
Characterize the symptoms: ❑ Flu like illness ❑ Lacrimation/rhinorrhea ❑ Sneezing ❑ Anorexia ❑ Nausea, vomiting & diarrhea | |||||||||||||||||||||||||||||||||||||||
Examine the patient: ❑ Pupillary dilatation ❑ Gooseflesh (piloerection) ❑ Yawning | |||||||||||||||||||||||||||||||||||||||
| Admit the patient | |||||||||||||||||||||||||||||||||||||||
Opioid agonists: ❑ Methadone 20-35 mg daily or ❑ Buprenorphine 4-16 mg daily ❑ Taper by 3% daily over next several days Nonopioid drugs: ❑ Clonidine 0.2 mg every 4 hours tapered after day 3 or ❑ Lofexidine 0.2 mg BD daily, titrated to 1.2 mg BD daily ❑ Treatment duration 10 days for heroin; 14 days for methadone | |||||||||||||||||||||||||||||||||||||||