Hey, I know I posted this once before but there are some nubies on here now that are going through or thinking about going through withdrawals. Like me, we all want to make it as painless as we can so here is the withdrawal flowchart- FLOWCHART FOR NARCOTIC WITHDRAWAL- hope this helps someone.

(1) Assessment Findings for Patients at Risk for Withdrawal
a. History of abuse or dependence.
b. High Index of Suspicion: positive urine drug screen (UDS), track marks

(2) If Not Already Done, Obtain:
a. Urine Drug Screen (UDS)
b. Behavioral Assessment Team (BAT)-ext.6387, BP2018 Consult for.
1. Withdrawal management recommendations
2. Community referrals or Turning Point outpatient assessment appointment (208-HOPE)
3. If pregnant or with severe cardiovascular or respiratory disease, consultation with a certified addictionologist is recommended.

(3) Acute withdrawal from narcotics is not life threatening. Treatment is aimed at managing the symptoms as they occur. (I)


(4) Guidelines for Managing Narcotic Withdrawal Symptoms:

Medication suggestions:
Catapres TTS 1,2 or 3 patch (clonidine) - apply the patch to counteract sympathetic hyperactivity associated with narcotic withdrawal. The size of the patch depends on amount of narcotic used, age & blood pressure. The patch is changed every 7-10 days. (Caution - use of the patch can cause orthostatic hypotension)

Paregoric 5 - 10ml po four times daily as needed for diarrhea and/or other early significant withdrawal symptoms. Contimue only for the first 2 days of symptomatic withdrawal.

Dicyclomine (Bentyl) 10 - 20mg po four times daily as needed for abdominal cramping

Methocarbamol (Robaxin) 750 - 1500mg po four times daily as needed for muscle aches

LorazePam. (Ativan) I - 2mg po/IM/IV every four hours as needed for anxiety

Trimethobenzamide (Tigan) 200mg IM/rectally or 250mg po three or four times daily as needed for nausea & vomiting
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