Opiate Withdrawal History and Physical Examination
Opiate withdrawal symptoms peak between 36-72 hours. Symptoms run their course in 5-7 days, though craving continues for some time.
Withdrawal from Heroin
Withdrawal from heroin may begin up to 8 hours after the last use. During the next few hours, the person experiences muscle pain, sneezing, sweating; tearfulness; yawning excessively. At 36 hours after the last use, symptoms are most severe. These symptoms include chills, muscle cramps, flushing, sweating, tachycardia, hypertension, inability to sleep, vomiting & diarrhoea. Symptoms typically continue for about 72 hours & gradually diminish over 5-10 days.
History
- Aap kia istemal karty
- Akhri bar kab lia hai aap ne
- Abhi dil chahta ke aap dobara se kar lyn? Kitna had tak?
- Gutno ya baqi jorhon mai dard ho raha hai? Baqi jisam or pat’tho mai takleef? Sar dard?
- Pait ma dard waghera? Ulti ya matli to nai arhaii? Pechas ya ihsal ki shikayat?
- Hot and cold flushes?
- Cheenk to naii a rahy baar baar?
- Nend kesi hai? Araam se soe rehty han?
- Koi bechainee, pareshani ki keffyat ya ghussa ata ho?
Physical examination
Start from the hands.- Inspect the hands and run a hand over the palm. Note any sweating or palmar erythema.
- Note if there is any piloerection if hair visible on the dorsal side of the hands.
- Then check the pulse.
- Inspect the arms for any signs of IV drug abuse.
- Check blood pressure, and then check the temperature.
- Check respiratory rate while checking the above.
- Inspect the face for lacrimation, rhinorrhea and check pupil size for dilation.
- Comment if the patient is shaking or yawning.
- Perform a cardiovascular examination and look for murmurs.
- Examine for the signs of liver failure