Withdrawal

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Intoxication and withdrawal symptoms are given across four major drug groups of Alcohol, Benzodiazepines, Opiates and Amphetamines. Some of the symptoms in mild to moderate withdrawal, while not life threatening, can result in extreme discomfort and should not be underestimated. These signs can be from other causes. For example, influenza symptoms can mimic opiate withdrawal; fatigue from hepatitis or diahorrea can resemble opiate intoxication. Careful assessment and/or toxicology should be undertaken to determine symptom causation. Rarely, the signs of intoxication identified in this chart can also result from withdrawal. If so, they may signal a severe withdrawal syndrome and medical attention should be sought immediately. Three of the main dangers of withdrawal are: Death from overdose while relapsing due to reduced tolerance Death from suicide if drug use is a primary coping mechanism if supports and underling social/pathology are not managed (eg coping with depression, family violence) Child and partner abuse from anxiety induced withdrawal symptoms.
Contents Drug Symptoms Chart (Intoxication & Withdrawal) Alcohol Tranquilizers Opoids Amphetamines Drugs & Pregnancy
Drug Symptoms Chart
A l c o h o l
Intoxication	Mild to Moderate Withdrawal	Severe Withdrawal
Ataxia (difficulty walking) Slurred speech Disinhibition Low blood pressure Smells of alcohol	Tremors Nausea Anxiety Sweats Sleep disturbances	Delirium Tremens (DT's) Visual, tactile or auditory hallucinations Seizure Vomiting & diahorrea Depression
T r a n q u i l i z e r s Benzodiazepines: eg Valium, Temazepam, Rohypnol, Serepax
Intoxication	Mild to Moderate Withdrawal	Severe Withdrawal
Slurred speech Ataxia Sedation Nystagmus (unusual eye movements) Low blood pressure Drooling Disinhibited	Anxiety Sleep disturbances Hypersensitivity to noise, light, touch Perceptual disturbance Feelings of unreality Memory impairment Headache Aches & pains Palpitations	Depression, Suicidal thoughts, Agoraphobia Seizure
Opoids Heroin, Methadone, Codeine
Intoxication	Mild to Moderate Withdrawal	Severe Withdrawal
Sedation Pinpoint pupils Low blood pressure Slowed pulse Itching & scratching	Lacrimination (runny eyes) Rhinorrhoea (runny nose) Perspiration Yawning Restlessness Insomnia Dilated pupils Anorexia/nausea Weakness Gooseflesh Muscle aches, leg cramps Joint pain, back ache, abdominal cramps Diarrhoea Hot and cold flushes Fatigue Drug seeking behaviour
A m p h e t a m i n e s Dexamphetamine (Speed). Ritalin, MDMA (Ecstasy)
Intoxication	Mild to Moderate Withdrawal	Severe Withdrawal
Agitation Irritability Grandiosity Dilated pupils Fine tremor Sweating Rapid speech & movement	Anxiety Agitation Depression Fatigue Extended sleep Increased appetite	Psychosis Suicidal thoughts Existential crisis
Drugs and Pregnancy While it is generally advisable to be drug-free during pregnancy (apart from the ones prescribed by a doctor), withdrawing from alcohol or other drugs while pregnant may carry risks. It is best to seek advice from a doctor or drugs specialist worker before either using or withdrawing from alcohol or other drug use while pregnant.
Much of this material was adapted from: Frank L, & Pead J, (1995) New Concepts in Drug Withdrawal: A Resource Handbook Monograph No 4 University of Melbourne and Department of Public Health and Community Medicine, Parkville. This excellent manual was developed as a part of the Services for Alcohol and Drug Withdrawal (SAW) Project in Victoria. Telephone (03) 344 4000 Fax (03) 344 5104 A valuable series of self-help books on stopping drug use and dealing with withdrawal called the Getting Through Withdrawal is available from Turning Point Alcohol & Drug Centre Inc. 54 Gertrude St, Fitzroy, Victoria 3065. Ph (03) 9254 8050 Fax (03) 9416 3420
Related Internet Links The following GP Information Supplements were developed by the NSW Central Coast Area Health Service and are located on the CEIDA web site in PDF format. Detoxification from Alcohol PDF 15 KB CEIDA Benzodiazepine Amphetamine Dependence & Withdrawal PDF 14 KB CEIDA Heroin Addiction (including intoxication & withdrawal information) PDF 17 KB CEIDA Cannabis Treatment & Dependence (including intoxication & withdrawal information) PDF 17 KB CEIDA Smoking Cessation PDF 15 KB CEIDA