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Opioid Abuse and Withdrawal Assessment

Poppy-droid Abused making a Withdraw with Assess-man
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Prolonged use of opioids leads to drug tolerance and dependency. This development of opioid abuse can stem from an individual increasing the amount and frequency of opioids taken to relieve pain from a medical issue. This abuse can also come from individuals obtaining opioids from illegal sources for recreational use. The Opioid Withdrawal Assessment is a tool used to evaluate symptoms frequently seen in opioid withdrawal patients. The Assessment is used to determine the patient's level of physical dependence on opioids. In order to minimize opioid abstinence syndrome, gradually taper the patient off opioids.
9 KEY FACTS
ABUSE ASSESSMENT
Euphoria
U-flowers

Euphoria is an exaggerated feeling of elation. Opioids activate the mu and kappa receptors and initially induce feelings of euphoria. Although opioids create euphoria and decrease pain perception, their pleasurable effect contributes to drug abuse.

Miosis
Mice-eyes

Opioids stimulate the oculomotor nerve and cause miosis by constricting the pupils to "pinpoint" sizes. Keep bright lights during the daytime to compensate for impaired vision related to miosis.

CNS Depression
Down-arrow CNS-brain

Opioids depress the central nervous system (CNS). Symptoms include drowsiness, mental clouding, impaired attention and memory, slurred speech, and psychomotor retardation. Patients should be advised to avoid hazardous activities, such as driving.

ABUSE WITHDRAWAL
Yawning
Yawning

Yawning is an initial reaction to abstinence syndrome in patients highly dependent on opioids. Although the exact mechanism of yawning remains undetermined, a greater presence of opioid neurotransmitters decreases the frequency of yawning. Therefore, the sudden absence of opioids results in increased yawning.

Gooseflesh
Goosebumps

The side effect of goosebumps leads to the term “Cold Turkey” with sudden cessation of opioids. Gooseflesh, or piloerection, is an involuntary reflex caused by sympathetic stimulation. During opioid withdrawal, the body attempts to compensate by overly stimulating the sympathetic system.

Sweating
Sweaty sweatband

With sudden opioid cessation, the body develops sympathetic hyperactivity, exemplified by diaphoresis or sweating.

Rhinorrhea
Runny-nose

Rhinorrhea can occur with abstinence syndrome in patients highly dependent on opioids. The patient will experience sympathetic hyperactivity as the body tries to compensate for lack of opioid stimulation. Rhinorrhea is a symptom caused by excessive sympathetic activity.

Kicking Movements
Kicking

Opioid abuse leads to constant physiological stimulation. During opioid withdrawal, the body reacts by manifesting with physical symptoms, such as uncontrollable kicking movements.

CONSIDERATION
Naloxone
Nail-lock

Opioid intoxication may be treated with the narcotic antagonist naloxone (Narcan). This medication is a competitive antagonist at opioid receptors and can reverse the opioid effects, such as sedation, euphoria, and analgesia. Naloxone will also create an immediate withdrawal reaction.

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