Substance-using
Women and Drug-exposed Infants |
|
|
|
Signs and Symptoms of Drug
Withdrawal
|
Alcohol
| Early symptoms of alcohol withdrawal generally appear 6 to 48
hours after drinking has stopped but can occur up to 10 days after the last drink.
Withdrawal symptoms may include: |
- • Restlessness
- • Tachycardia
- • Irritability
- • Hypertension
- • Anorexia
|
- • Insomnia
- • Nausea
- • Nightmares
- • Vomiting
- • Impaired concentration
|
- • Sweating
- • Impaired memory
- • Tremors
- • Elevated vital signs
|
|
| More severe symptoms of alcohol withdrawal may include |
- • Increased tremulousness
- • Increased agitation
- • Increased sweating
- • Delirium (with confusion, disorientation,
impaired memory and judgment)
|
- • Hallucinations (auditory, visual, or tactile)
- • Delusions (usually paranoid)
- • Grand mal seizures
|
|
| Note: Withdrawal symptoms do not necessarily progress from mild to
severe. In some individuals, a grand mal seizure may be the first sign of withdrawal.
Seizures usually occur 12 to 24 hours after cessation or reduction of drinking. One-third
of all patients who have seizures develop delirium tremens. |
|
Opioids
| Mild withdrawal signs and symptoms include: |
- • Generalized anxiety
- • Opioid craving
- • Restlessness
|
- • Slight aching of muscles, joints, and bones
- • Lower back pain
|
|
| Mild to moderate withdrawal signs and symptoms include: |
- • Tension
- • Yen sleep (mild insomnia)
- • Mydriasis (pupils dilated)
|
- • Lethargy
- • Diaphoresis (usually perspiration)
|
|
| Moderate withdrawal signs and symptoms include: |
- • Chills alternating with flushing and
diaphoresis (sweating)
- • Rhinorrhea (runny nose)
- • Moderate aching of muscles,
joints and bones
- • Lower back pain
- • Anorexia
|
- • Nausea and/or stomach cramps
- • Yawning
- • Lacrimation (tearing)
- • Goose flesh (earlier if client is in
a cold, drafty room)
- • Elevated pulse and blood pressure
|
|
| Moderate to severe withdrawal signs and symptoms include: |
- • Tachycardia
- (pulse over 100 BPM)
- • Increased respiratory rate and depth
|
- • Diarrhea
- • Vomiting
- • Tremors
|
|
| Severe withdrawal signs and symptoms include: |
- • Doubling over with stomach cramps
- • Kicking movements
|
- • Elevated temperature
- (usually low grade, less than 100 degrees F)
|
|
| Note: Withdrawal signs and symptoms differ in their order of
appearance from one individual to another. Some individuals may not exhibit certain
withdrawal signs and symptoms. Signs may also include uterine irritability, increased
fetal activity, or rarely, hypotension. |
|
Barbiturate Abstinence Syndrome
| The barbiturate abstinence syndrome begins 6 to 24 hours after the last
dose, and symptoms are generally more severe with the short-acting barbiturates. Signs and
symptoms of barbiturate abstinence include: |
- • Tremulousness
- • Diaphoresis
- • Anxiety
- • Postural hypotension
- • Insomnia
- • Grand mal convulsions
- (between days 3 and 7)
|
- • Agitation
- • Anorexia
- • Delirium
- • Nausea and vomiting
- • Tendon hyperreflexia
|
|
| Note: If untreated, withdrawal symptoms can progress to
hyperpyrexia, electrolyte abnormalities, cardiovascular collapse, and death. |
|
Cocaine
| Withdrawal from cocaine dependence is characterized by depression,
anxiety, and lethargy, which begin to resolve after approximately 1 week. Less common are
signs of a paranoid psychosis during withdrawal from chronic use of high doses of cocaine.
In cocaine withdrawal, medication is rarely needed for the serious sequelae that are
associated with alcohol, barbiturate, and opioid withdrawal. |
|
|