Recognizing Opioid Withdrawal
In many patients, you will able to identify opioid withdrawal by observing the patient and through physical exam.
Look for the following signs and symptoms of withdrawal:
- drug craving
- anxiety
- drug-seeking behavior
- yawning
- sweating
- lacrimation
- rhinorrhea
- mydriasis
- gooseflesh
- muscle twitching
- anorexia
- insomnia
- increased pulse, respiratory rate, and blood pressure
- abdominal cramps
- vomiting
- diarrhea
- weakness
You may wish to use the Clinical Opioid Withdrawal Scale, or COWS (see link below), to assess a patient's level of withdrawal. Many clinicians use this assessment tool with patients during the first stages of buprenorphine induction.
Related Resources:
DSM IV Criteria for Opioid Withdrawal
Description:
Lists DSM-IV Criteria for Opioid Withdrawal A. Either of the following:
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cessation of (or reduction in) opioid use that has been heavy and prolonged (several weeks or longer)
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Description:
This PDF Document contains the Clinical Opioid Withdrawal Scale (COWS), a common instrument used to assess a patient's opioid withdrawal severity.
Source:
California Society of Addiction Medicine (CSAM) (5 votes)
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Description:
A checklist that allows the physician to determine if the patient is in withdrawal in order to administer initial buprenorphine dose.
Source:
American Academy of Addiction Psychiatry (AAAP) (3 votes)
Tags:
DSM IV Criteria for Opioid Withdrawal
