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Substance-using Women and Drug-exposed Infants: 
Module Two - Other Drugs
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Signs and Symptoms of Drug Withdrawal

cyan_bul.gif (1138 bytes) 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.

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Page last updated May 05, 2001