Patient education: Opioid withdrawal – ED discharge instructions (The Basics)

What are discharge instructions? — 

Discharge instructions are information about how to take care of yourself after getting medical care in the emergency department ("ED").

What should I know? — 

You came to the ED because you stopped taking an opioid you are used to taking, took less than you usually take, or were treated for an overdose with naloxone. (Naloxone is a medicine that reverses the effects of opioids.) Then, you started having symptoms. These symptoms are called "withdrawal."

Opioids are medicines used to treat pain. Examples include morphine, fentanyl, and oxycodone. The illegal drug heroin is also an opioid.

You might have "withdrawal symptoms". These can include:

●Cravings

●Restlessness or agitation

●Nausea or vomiting

●Muscle or joint aches

●Watery eyes or runny nose

●Goose bumps or sweating

●Abdominal pain or diarrhea

●Yawning

These symptoms gradually get worse before they start to improve. After about a week to 10 days, symptoms are usually gone. But cravings for opioids can persist. It depends on what opioid you were taking, how you were taking it, and if you were taking another substance as well.

The doctor might have given you medicines to help reduce cravings or to treat your withdrawal symptoms. Take the medicines exactly as instructed. If they did not give you any medicines, ask if a medicine such as buprenorphine or methadone is appropriate for you.

The doctor thinks it is safe for you to manage your withdrawal at home and with some support.

How do I care for myself at home? — 

Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You should also:

●Call your regular doctor and tell them you were in the ED. Make a follow-up appointment.

●Keep naloxone with you at all times. Make sure you, your family, and your friends know how and when to use it.

●Ask someone to stay with you for the next 1 to 2 days to watch and help you manage the withdrawal. Make sure they know when to call for help.

●Set up an appointment with a substance misuse specialist or clinic, therapist, or counselor to talk about your opioid use, your thoughts, and your feelings. Counseling can be 1 on 1, in a group, or with family members.

●Consider joining a support group such as Narcotics Anonymous ("NA") or SMART Recovery. It can help to connect with people who are going through similar things.

When should I get emergency help?

●Call for emergency help right away (in the US and Canada, call 9-1-1) if you:

•Turn blue or stop breathing – Whoever is staying with you should have naloxone available and know how to give it.

•Think you might harm yourself or someone else. In the US, you can contact the 988 Suicide & Crisis Lifeline:

-To speak to someone, call or text 988.

-To talk to someone online, go to chat.988lifeline.org.

●Return to the ED if you:

•Have a fever higher than 100.4°F (38°C)

•Have chest or belly pain

•Feel like your heart is beating very fast or slow

•Feel your withdrawal symptoms are severe, or need more help managing them

When should I call the doctor? — 

Call for advice if you:

●Feel very agitated

●Feel very weak or tired

●Have new or worsening symptoms

More on this topic

Patient education: Taking opioids safely (The Basics)
Patient education: Opioid overdose (The Basics)
Patient education: Opioid use disorder (The Basics)
Patient education: Prescription drug misuse (The Basics)
Patient education: Treatment for substance use disorder (The Basics)
Patient education: How to give naloxone (The Basics)