Editing Mental Health and Psychosocial Nursing (section)

=== Opioids ===
Intoxication: pinpoint pupils, respiratory depression, sedation, hypotension, decreased bowel sounds. '''Naloxone''' reverses it; monitor for re-sedation because naloxone has a shorter half-life than many opioids, and expect abrupt withdrawal in dependent clients.

Withdrawal (COWS scale): lacrimation, rhinorrhea, yawning, mydriasis, piloerection, myalgia, abdominal cramping, vomiting, diarrhea. It is intensely uncomfortable but '''not usually life-threatening in healthy adults''', unlike alcohol and sedative withdrawal, which can kill. Neonatal opioid withdrawal, by contrast, is dangerous and requires swaddling, low stimulation, small frequent feedings, and scoring-based pharmacologic treatment.

Treatment: methadone (full agonist, clinic-dispensed), buprenorphine or buprenorphine-naloxone (partial agonist), and naltrexone (antagonist, requires 7 to 10 days opioid-free first).