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DSM-IV & DSM-IV-TR:

Opioid Withdrawal

The brain adapts to use of alcohol and some other drugs in such a way that symptoms may result when the substance is reduced or discontinued, leading to diagnosis of this Substance-Related Disorder. This varies in intensity from no detectable symptoms to extreme discomfort with opioid withdrawal.

  • Grade 0: craving, anxiety, drug-seeking behavior
  • Grade 1: yawning, sweating, lacrimation, rhinorrhea
  • Grade 2: mydriasis, gooseflesh, muscle twitching, anorexia
  • Grade 3: Insomnia, increased pulse, respiratory rate and blood pressure, abdominal cramps, vomiting, diarrhea, weakness

Diagnostic criteria for 292.0 Opioid Withdrawal 
(cautionary statement)  

A. Either of the following: 

(1) cessation of (or reduction in) opioid use that has been heavy and prolonged (several weeks or longer) 
(2) administration of an opioid antagonist after a period of opioid use 

B. Three (or more) of the following, developing within minutes to several days after Criterion A: 

(1) dysphoric mood
(2) nausea or vomiting 
(3) muscle aches 
(4) lacrimation or rhinorrhea 
(5) pupillary dilation, piloerection, or sweating 
(6) diarrhea 
(7) yawning 
(8) fever 
(9) Insomnia

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association
 
Books and Other Media:
Follow the hypertext link to purchase items.

  • The Basketball Diaries Leonardo DiCaprio, Lorraine Bracco, Marilyn Sokol, and James Madio 1995
  • Burroughs, William S: Naked Lunch Paperback 1992 This is a brutally graphic account of heroin addiction on the streets of New York.
  • Candy DVD Abbie Cornish, Heath Ledger 2005
  • Fix Olivia Wilde, Shawn Andrews, Megalyn Echikunwoke, and Dedee Pfeiffer 2008
  • Georgia Jennifer Jason Leigh, Mare Winningham, Ted Levine, and Max 1995
  • Pure Molly Parker, Keira Knightley, Harry Eden, and David Wenham 2005
  • Ray DVD Jamie Foxx 2004
  • Trainspotting DVD Ewan McGregor 1995 Could this be the Naked Lunch of heroin addiction in '90's Edinburgh?


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