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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