COLD TURKEY: MANAGEMENT OPTIONS FOR OPIOID WITHDRAWAL

COL D T UR K E Y:

ED MANAG E ME NT OP T I ONS FOR OP I OI D W I T H DR AWAL

Lewis S. Nelson, M.D.

Rutgers

New Jersey Medical School

LEWIS S. NELSON, MD

D E PA RT M E NNewark,

T O F E MNew

E R G Jersey

ENCY MEDICINE

RU T G E R S , N E W J E R S E Y M E D I C A L S C H O O L

THE WELL INTENDED BYSTANDER

? A 28-year-old man with a long opioid use

history is ¡°found down¡± by police

? Intranasal naloxone is administered

? EMS is called

? COWS 30

Naloxone precipitated withdrawal

Onset 1 min, duration 45 min

Severity

Short acting: Heroin, oxycodone

Onset 6 hours, duration 5-8 days

Long acting: Methadone

Onset 18-36 hours, duration 10-14 days

Days

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