Substance Withdrawal Recognition

By VeriScorePrep Team · 5 min

Withdrawal can be life-threatening. Recognition guides safe management.

Alcohol withdrawal

Timeline: 6–24 hours after last drink, peaking around 24–72 hours. Mild: tremors, anxiety, insomnia, sweating, GI upset. Severe: seizures (6–48 hours), hallucinosis (12–48 hours), delirium tremens (48–96 hours) — confusion, hallucinations, fever, tachycardia, hypertension, mortality up to 5%. Medication: benzodiazepines, tapered using CIWA-Ar score. Thiamine before glucose to prevent Wernicke encephalopathy.

Opioid withdrawal

Timeline: 8–24 hours for short-acting opioids; up to 30 hours for long-acting. Signs: dysphoria, anxiety, runny nose, watery eyes, goosebumps, sweating, muscle aches, vomiting, diarrhea, dilated pupils, yawning. Uncomfortable but rarely life-threatening in adults. Manage with methadone, buprenorphine, and symptom relief.

Sedative-hypnotic withdrawal

Barbiturate and benzodiazepine withdrawal can be severe and life-threatening with seizures — taper rather than stop abruptly.

Nursing

Monitor vital signs, hydration, orientation, and seizure precautions. Provide a calm environment. Coordinate with addiction specialists and offer resources for long-term recovery.