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Opiate Withdrawal Syndrome

MedGen UID:
476135
•Concept ID:
C3274502
•
Mental or Behavioral Dysfunction

Definition

A syndrome that is defined by signs and symptoms related to abrupt or gradual stoppage of opioids use. They include strong cravings, sweating, nausea, vomiting, irritation, anxiety, muscle pain, dilated pupils and insomnia. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVOpiate Withdrawal Syndrome

Professional guidelines

PubMed

Adjunctive memantine for opioid use disorder treatment: A systematic review.
Elias AM, Pepin MJ, Brown JN
J Subst Abuse Treat 2019 Dec;107:38-43. Epub 2019 Oct 20 doi: 10.1016/j.jsat.2019.10.003. PMID: 31757263
Management of precipitated opiate withdrawal syndrome induced by nalmefene mistakenly prescribed in opiate-dependent patients: a review for clinicians.
Franchitto N, Jullian B, Salles J, Pelissier F, Rolland B
Expert Opin Drug Metab Toxicol 2017 Jun;13(6):669-677. Epub 2017 Apr 3 doi: 10.1080/17425255.2017.1312340. PMID: 28343423
Clonidine and the treatment of the opiate withdrawal syndrome.
Gossop M
Drug Alcohol Depend 1988 Jul;21(3):253-9. doi: 10.1016/0376-8716(88)90078-6. PMID: 3048954

Recent clinical studies

Etiology

Understanding barriers to timely identification of infants at risk of neonatal opiate withdrawal syndrome.
Howell MP, Smith AM, Lindsay EB, Drury SS
J Matern Fetal Neonatal Med 2021 Apr;34(7):1161-1166. Epub 2019 Jun 14 doi: 10.1080/14767058.2019.1627316. PMID: 31195865
Delivery dose of methadone, but not buprenorphine, is associated with the risk and severity of neonatal opiate withdrawal syndrome.
Lappen JR, Stark S, Bailit JL, Gibson KS
Am J Obstet Gynecol MFM 2020 Feb;2(1):100075. Epub 2019 Dec 10 doi: 10.1016/j.ajogmf.2019.100075. PMID: 33345989
Management of precipitated opiate withdrawal syndrome induced by nalmefene mistakenly prescribed in opiate-dependent patients: a review for clinicians.
Franchitto N, Jullian B, Salles J, Pelissier F, Rolland B
Expert Opin Drug Metab Toxicol 2017 Jun;13(6):669-677. Epub 2017 Apr 3 doi: 10.1080/17425255.2017.1312340. PMID: 28343423
Opiate withdrawal syndrome in buprenorphine abusers admitted to a rehabilitation center in Tunisia.
Derbel I, Ghorbel A, Akrout FM, Zahaf A
Afr Health Sci 2016 Dec;16(4):1067-1077. doi: 10.4314/ahs.v16i4.24. PMID: 28479900Free PMC Article
Detoxification of nonopiate drugs in the chronic pain setting and clonidine opiate detoxification.
Fishbain DA, Rosomoff HL, Rosomoff RS
Clin J Pain 1992 Sep;8(3):191-203. doi: 10.1097/00002508-199209000-00003. PMID: 1421732

Diagnosis

Understanding barriers to timely identification of infants at risk of neonatal opiate withdrawal syndrome.
Howell MP, Smith AM, Lindsay EB, Drury SS
J Matern Fetal Neonatal Med 2021 Apr;34(7):1161-1166. Epub 2019 Jun 14 doi: 10.1080/14767058.2019.1627316. PMID: 31195865
A Practical Approach to Neonatal Opiate Withdrawal Syndrome.
Devlin LA, Davis JM
Am J Perinatol 2018 Mar;35(4):324-330. Epub 2017 Nov 3 doi: 10.1055/s-0037-1608630. PMID: 29100261
Opiate withdrawal syndrome mimicking postoperative intestinal obstruction.
Macutkiewicz C, Anwar S, Babbs C, Burnett H, Carlson GL
Ann R Coll Surg Engl 2004 Mar;86(2):96-8. doi: 10.1308/003588404322827464. PMID: 15005926Free PMC Article
Two new rating scales for opiate withdrawal.
Handelsman L, Cochrane KJ, Aronson MJ, Ness R, Rubinstein KJ, Kanof PD
Am J Drug Alcohol Abuse 1987;13(3):293-308. doi: 10.3109/00952998709001515. PMID: 3687892
Clonidine in opiate withdrawal: review and appraisal of clinical findings.
Washton AM, Resnick RB
Pharmacotherapy 1981 Sep-Oct;1(2):140-6. doi: 10.1002/j.1875-9114.1981.tb03561.x. PMID: 6765486

Therapy

Understanding barriers to timely identification of infants at risk of neonatal opiate withdrawal syndrome.
Howell MP, Smith AM, Lindsay EB, Drury SS
J Matern Fetal Neonatal Med 2021 Apr;34(7):1161-1166. Epub 2019 Jun 14 doi: 10.1080/14767058.2019.1627316. PMID: 31195865
A Practical Approach to Neonatal Opiate Withdrawal Syndrome.
Devlin LA, Davis JM
Am J Perinatol 2018 Mar;35(4):324-330. Epub 2017 Nov 3 doi: 10.1055/s-0037-1608630. PMID: 29100261
Management of precipitated opiate withdrawal syndrome induced by nalmefene mistakenly prescribed in opiate-dependent patients: a review for clinicians.
Franchitto N, Jullian B, Salles J, Pelissier F, Rolland B
Expert Opin Drug Metab Toxicol 2017 Jun;13(6):669-677. Epub 2017 Apr 3 doi: 10.1080/17425255.2017.1312340. PMID: 28343423
Clonidine and the treatment of the opiate withdrawal syndrome.
Gossop M
Drug Alcohol Depend 1988 Jul;21(3):253-9. doi: 10.1016/0376-8716(88)90078-6. PMID: 3048954
Clonidine and alcohol withdrawal.
Cushman P Jr
Adv Alcohol Subst Abuse 1987;7(1):17-28. PMID: 3327372

Prognosis

Opiate withdrawal syndrome in buprenorphine abusers admitted to a rehabilitation center in Tunisia.
Derbel I, Ghorbel A, Akrout FM, Zahaf A
Afr Health Sci 2016 Dec;16(4):1067-1077. doi: 10.4314/ahs.v16i4.24. PMID: 28479900Free PMC Article
Benzodiazepine co-dependence exacerbates the opiate withdrawal syndrome.
de Wet C, Reed L, Glasper A, Moran P, Bearn J, Gossop M
Drug Alcohol Depend 2004 Oct 5;76(1):31-5. doi: 10.1016/j.drugalcdep.2004.04.002. PMID: 15380286
24-Hour opiate detoxification and antagonist induction at home--the 'Asturian method': a report on 1368 procedures.
Carreño JE, Bobes J, Brewer C, Alvarez CE, San Narciso GI, Bascarán MT, Sánchez del Río J
Addict Biol 2002 Apr;7(2):243-50. doi: 10.1080/135562102200120479. PMID: 12006220
Naltrexone and lofexidine combination treatment compared with conventional lofexidine treatment for in-patient opiate detoxification.
Buntwal N, Bearn J, Gossop M, Strang J
Drug Alcohol Depend 2000 May 1;59(2):183-8. doi: 10.1016/s0376-8716(99)00116-7. PMID: 10891632
An investigation of withdrawal symptoms shown by opiate addicts during and subsequent to a 21-day in-patient methadone detoxification procedure.
Gossop M, Bradley B, Phillips GT
Addict Behav 1987;12(1):1-6. doi: 10.1016/0306-4603(87)90002-5. PMID: 3565107

Clinical prediction guides

Delivery dose of methadone, but not buprenorphine, is associated with the risk and severity of neonatal opiate withdrawal syndrome.
Lappen JR, Stark S, Bailit JL, Gibson KS
Am J Obstet Gynecol MFM 2020 Feb;2(1):100075. Epub 2019 Dec 10 doi: 10.1016/j.ajogmf.2019.100075. PMID: 33345989
Opiate withdrawal syndrome in buprenorphine abusers admitted to a rehabilitation center in Tunisia.
Derbel I, Ghorbel A, Akrout FM, Zahaf A
Afr Health Sci 2016 Dec;16(4):1067-1077. doi: 10.4314/ahs.v16i4.24. PMID: 28479900Free PMC Article
Benzodiazepine co-dependence exacerbates the opiate withdrawal syndrome.
de Wet C, Reed L, Glasper A, Moran P, Bearn J, Gossop M
Drug Alcohol Depend 2004 Oct 5;76(1):31-5. doi: 10.1016/j.drugalcdep.2004.04.002. PMID: 15380286
The influence of heroin dose and route of administration on the severity of the opiate withdrawal syndrome.
Smolka M, Schmidt LG
Addiction 1999 Aug;94(8):1191-8. doi: 10.1046/j.1360-0443.1999.94811919.x. PMID: 10615734
Clonidine and alcohol withdrawal.
Cushman P Jr
Adv Alcohol Subst Abuse 1987;7(1):17-28. PMID: 3327372

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