Data gathering
- Red flags – vomiting, muscle aches, chest pain, SOB
- Others – injected, mood, self harm, hallucinations
- Examine – BP, pulse, injection sites
Clinical management
- Investigations
- Urine drug screen
- Bloods – HIV, HBV, HCV
- ECG
- Explanation
- Opiate use over a long time can reduce the amount of natural painkillers (endorphins) that your body produces leading to dependency and withdrawal
- Treatment
- IV drug use – HBV immunisation, needle exchange, don’t share needles
- Local drug services – support, detoxification (methadone/buprenorphine)
- CBT
- Social needs – housing, benefits, DVLA
- Follow-up / Safety net
NB:
- Opiate withdrawal – abdo pain, vomiting, diarrhoea, dilated pupil, sweats, runny nose
- Although uncomfortable, cannot die from withdrawal (unlike alcohol withdrawal)