User:Mr. Ibrahem/Opioid withdrawal
| Mr. Ibrahem/Opioid withdrawal | |
|---|---|
| Other names | Opioid withdrawal syndrome (OWS), dope sick |
 | |
| Course of opioid withdrawal[1] | |
| Specialty | Emergency medicine, psychiatry |
| Symptoms | Runny nose, large pupils, goose bumps, muscle pains, nausea, diarrhea, sweating, fast heart rate, yawning[2] |
| Complications | Dehydration, electrolyte abnormalities[3] |
| Duration | 1-2 week[4][5] |
| Causes | Sudden reduction of opioids or an opioid antagonist[4] |
| Differential diagnosis | Withdrawal from other drugs, stimulant toxicity, opioid use disorder[2][4] |
| Treatment | Opioid replacement therapy (ORT), clonidine, metoclopramide, loperamide[5] |
Opioid withdrawal is a set of symptoms arising from the sudden reduction of opioids or an opioid antagonist after a period of opioid use.[4] Symptoms may include a runny nose, large pupils, goose bumps, muscle pains, nausea, diarrhea, sweating, fast heart rate, and yawning.[2] Symptoms may last a few days.[3] While rarely life threatening, complications may include dehydration and electrolyte abnormalities.[3][6]
All opioids can be followed by withdrawal, regardless of if they were used recreational or by prescription.[4][7] Onset may occur as early as 6 hours following the use of short acting opioids like heroin or as late as 4 days following the use of long acting agents like methadone.[4] Severity of withdrawal is often based on a Clinical Opioid Withdrawal Scale (COWS).[2]
Opioid withdrawal can be treated with opioid replacement therapy (buprenorphine or methadone).[6][5] Symptoms may be improved with clonidine or lofexidine.[8] Without treatment the worst of the symptoms last about a week, though minor symptoms may remain for longer.[4]
About 16 million people use opioids illegally globally.[2] In those who have used heroin in the prior year, withdrawal had occurred in about 60% of them.[4] Many people who continue opioid use, do so in an effort to prevent withdrawal.[5] Opioid withdrawal may have been described as early as the 5th century BC by Hippocrates.[9] Descriptions in the medical literature date to at least 1701.[10]
References[edit]
- ^ Lerner, A; Klein, M (2019). "Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development". Brain communications. 1 (1): fcz025. doi:10.1093/braincomms/fcz025. PMID 32954266.
- ^ a b c d e Shah, M; Huecker, MR (January 2021). "Opioid Withdrawal". PMID 30252268.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c Volkow, Nora D.; Blanco, Carlos (2020-01-02). "Medications for opioid use disorders: clinical and pharmacological considerations". The Journal of Clinical Investigation. 130 (1): 10–13. doi:10.1172/JCI134708. ISSN 0021-9738. PMC 6934219. PMID 31763992.
- ^ a b c d e f g h Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). American Psychiatric Association. 2013. pp. 547–549. ISBN 9780890425541.
- ^ a b c d Kosten, TR; Baxter, LE (February 2019). "Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment". The American journal on addictions. 28 (2): 55–62. doi:10.1111/ajad.12862. PMID 30701615.
- ^ a b Srivastava, AB; Mariani, JJ; Levin, FR (2020-06-20). "New directions in the treatment of opioid withdrawal". Lancet (London, England). 395 (10241): 1938–1948. doi:10.1016/S0140-6736(20)30852-7. PMID 32563380.
- ^ Treatment, Center for Substance Abuse (2006). 4 Physical Detoxification Services for Withdrawal From Specific Substances. Substance Abuse and Mental Health Services Administration (US). Retrieved 19 May 2021.
- ^ Rehman, Saif Ur; Maqsood, Muhammad Haisum; Bajwa, Hamza; Tameez Ud Din, Asim; Malik, Mustafa N (2019). "Clinical Efficacy and Safety Profile of Lofexidine Hydrochloride in Treating Opioid Withdrawal Symptoms: A Review of Literature". Cureus. 11 (6): e4827. doi:10.7759/cureus.4827. ISSN 2168-8184. PMC 6682385. PMID 31403015.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Zaoutis, Lisa B.; Chiang, Vincent W. (2007-01-01). Comprehensive Pediatric Hospital Medicine. Elsevier Health Sciences. p. 286. ISBN 978-0-323-03004-5.
- ^ Abuse, United States Commission on Marihuana and Drug (1973). Drug Use in America: Problem in Perspective: Second Report. U.S. Government Printing Office. p. 305. Retrieved 19 May 2021.