Transcript Drug Intoxication and Withdrawal

Drug Intoxication and
Withdrawal: Signs and
Symptoms
Alcohol Intoxication
• Recent ingestion of alcohol
• Clinically significant maladaptive
behavioral or psychological changes (e.g.,
inappropriate sexual or aggressive
behaviors).
• One or more the the following:
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Slurred speech
Incoordination
Unsteady gait
Nystagmus
-Impairment in attention or
memory
-Stupor or coma
Alcohol Withdrawal
• Cessation of (or reduction in) alcohol use that has
been heavy and prolonged.
• Two (or more) of the following:
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Autonomic hyperactivity (sweating, high pulse rate).
Increased hand tremor
-Anxiety
Insomnia
-Grand mal seizures
Nausea/vomiting
Psychomotor agitation
Transient visual, tactile, or auditory hallucinations or
illusions
Sedative/Hypnotic/Anxioly
tic Intoxication
• Clinically significant maladaptive behavioral or
psychological changes (e.g., mood lability,
inappropriate sexual or aggressive behavior).
• One or more of the following signs:
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Slurred speech
-Incoordination
Unsteady gait
-Nystagmus
Impairment in attention or memory
Stupor or coma
• Symptoms not due to GMC or other mental disorder
Sedative/Hypnotic/Anx
iolytic Withdrawal
• Two or more of the following:
– Autonomic hyperactivity (e.g. sweating or PR
>100)
– Increased hand tremor
-Anxiety
– Insomnia
-Nausea or vomiting
– Psychomotor agitation
-Grand mal seizures
– Transient visual, tactile, or auditory
hallucinations or illusions
Amphetamine Intoxication
• Recent use of amphetamine
• Clinically significant maladaptive behavioral or
psychological changes (e.g., euphoria, hypervigilance).
• 2 or more of the following:
– Tachycardia or bradycardia
– Perspiration or chills
– Evidence of weight loss
- Pupillary dilation
- Nausea or vomiting
-Elevated or lowered
blood pressure
Amphetamine Intoxication
(Cont’d)
– Psychomotor agitation or retardation
– Muscular weakness, respiratory depression,
chest pain, or cardiac arrhythmias
– Confusion , seizures, dyskinesias, dystonias,
or coma
– Not due to GMC or another mental disorder
Amphetamine Withdrawal
• Cessation of heavy amphetamine use
• Dysphoric mood, and two or more of the following:
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Fatigue
Vivid, unpleasant dreams
Insomnia or hypersomnia
Increased appetite
Psychomotor retardation or agitation
• Symptoms cause clinically significant distress or
impairment in social, occupational, or other
important areas of functioning
• Not due to GMC or other mental disorder
Cocaine Intoxication
• Clinically sig. maladaptive behavioral or
psychological changes (e.g., euphoria, tension, etc.).
• Two or more of the following:
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Tachycardia or bradycardia
-Nausea or vomiting
Pupillary dilation
-Perspiration or chills
Elevated or lowered blood pressure
Evidence of weight loss
Cocaine Intoxication (Cont’d)
– Psychomotor agitation or retardation
– Muscular weakness, respiratory depression,
chest pain, or cardiac arrhythmias
– Confusion, seizures, dyskinesias, dystonias, or
coma
– Not due to GMC or other mental disorder
Cocaine Withdrawal
• Dysphoric mood and two or more of the following:
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Fatigue
Vivid unpleasant dreams
Insomnia or hypersomnia
Increased appetite
Psychomotor retardation or agitation
• Symptoms cause clinically significant distress or
impairment in social, occupational, or other areas of
functioning
• Symptoms not due to GMC or other mental disorder.
Caffeine
Intoxication
• Recent consumption of caffeine
• Five of the following signs:
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Restlessness
Excitement
Flushed face
Gastrointestinal disturbance
Rambling flow of thought or speech
Tachycardia or cardiac arrhythmia
Periods of inexhaustibility
Psychomotor agitation
-Nervousness
-Insomnia
-Diuresis
-Muscle twitching
Caffeine
Intoxication (Cont’d)
• Symptoms cause clinically significant distress or
impairment in social, occupational, or other
important areas of functioning.
• Symptoms are not the result of a GMC or other
mental disorder.
Nicotine Withdrawal
• Daily use of nicotine for at least several weeks
• Abrupt cessation of nicotine use followed within 24
hours by four or more of the following:
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Dysphoric or depressed mood -Insomnia
Irritability, frustration, or anger -Anxiety
Difficulty concentrating
-Restlessness
Decreased heart rate
Increased appetite or weight gain
• Symptoms cause significant distress in functioning
• Symptoms not due to GMC or other mental disorder
Opioid Intoxication
• Clinically significant maladaptive behavioral or
psychological changes (e.g., dysphoria, impaired
judgment, euphoria followed by apathy).
• Pupillary constriction (or dilation due to anoxia from
severe overdose) and at least one of the following:
– Drowsiness or coma
-Slurred speech
– Impairment in attention or memory
• Symptoms not due to GMC or other mental disorder
Opioid Withdrawal
• Three (or more) of the following:
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Dysphoric mood
-Nausea or vomiting
Muscle aches
-Lacrimation or rhinorrhea
Diarrhea
-Yawning
Fever
-Insomnia
Pupillary dilation, piloerection, or sweating
• Symptoms cause significant distress or impairment
in functioning
• Symptoms not due to GMC or other mental disorder
Cannabis Intoxication
• Recent use
• Clinically significant maladaptive behavioral or
psychomotor changes (e.g., euphoria, anxiety).
• Two or more of the following signs:
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Conjunctival injection
Increased appetite
Dry mouth
Tachycardia
• Symptoms not due to GMC or other mental disorder
Hallucinogen Intoxication
• Clinically significant maladaptive behavior or
psychomotor changes (e.g., paranoid ideation, fear
of losing one’s mind).
• Perceptual changes occurring in a state of full
wakefulness and alertness (e.g., depersonalization,
illusions, etc.).
• Two or more of the following:
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Pupillary dilation
Tachycardia
Sweating
palpitations
-Blurring of vision
-Tremors
-Incoordination
Hallucinogen Flashbacks
• Re-experiencing one or more perceptual symptoms
that were first experienced while intoxicated by a
hallucinogen (e.g., flashes of color, positive afterimages).
• Symptoms cause clinically significant distress or
impairment
• Symptoms are not due to a GMC or other mental
disorder
Inhalant Intoxication
• Clinically significant maladaptive behavioral or
psychological changes (e.g., belligerence, apathy,
etc.)
• Two or more of the following signs:
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Dizziness
Incoordination
Unsteady gait
Depressed reflexes
Tremors
Euphoria
Stupor or coma
-Nystagmus
-Slurred speech
-Lethargy
-Psychomotor retardation
-Generalized muscle weakness
-Blurred vision or diplopia
Phencyclidine Intoxication PCP
• Clinically significant maladaptive behavioral
changes (e.g., belligerence, impulsiveness, etc.)
• Within an hour, two or more of the following:
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Hypertension or tachycardia
-Hyperacusis
Ataxia
-Dysarthria
Muscle rigidity
-Seizures or coma
Numbness or diminished responsiveness to pain
Vertical or horizontal nystagmus
• Symptoms are not due to GMC or other mental
disorder