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Suspected Substance Withdrawal in Adolescents — Cohort — Clinical Pathway: Inpatient

Suspected Substance Withdrawal in Adolescents Clinical Pathway — Inpatient

Adolescent with Suspected Substance Withdrawal

This pathway guides the care of adolescents with suspected acute withdrawal from alcohol, benzodiazepines and/or opioids with:

  • Referral from outside hospitals, psychiatric inpatient units, or crisis response centers for suspected withdrawal
  • Presence of unprescribed drugs noted during admission, during search of belongings
  • Disclosed usage
  • Positive urine drug screen for alcohol, benzodiazepine, or opioid

This pathway does not guide the care of inpatients treated with prolonged courses of benzodiazepines or opioids.

General Signs and Symptoms of Withdrawal

Alcohol/Benzodiazepines Opioids
  • Clouded sensorium, disorientation
  • Restlessness, anxiety, agitation
  • Mydriasis
  • Diaphoresis, rhinorrhea
  • Tachycardia, elevated BP
  • Nausea, vomiting, abdominal cramping, diarrhea
  • Headache, seizure, tremor
  • Auditory, visual and/or tactile disturbances
  • Restlessness, anxiety, agitation
  • Lacrimation, mydriasis
  • Diaphoresis, rhinorrhea
  • Tachycardia, elevated BP
  • Nausea, vomiting, abdominal cramping, diarrhea
  • Tremor, myalgia, arthralgia
  • Tactile disturbances
Note: Withdrawal symptoms may present up to 72 hrs after last use

Toxidromes and Substance Effects

Other Factors to Consider

 

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