Opiate addiction

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


  • Opiate withdrawal – abdo pain, vomiting, diarrhoea, dilated pupil, sweats, runny nose
  • Although uncomfortable, cannot die from withdrawal (unlike alcohol withdrawal)