Lab findings may reveal opiates on the tox screen, increased transaminases, or decreased globulins. With more severe intoxication respiratory depression, coma, and death may ensue. As respiratory depression worsens, pupils may become dilated. Patient's respiratory status should be monitored. Naloxone 0.4 mg iv may need to be administered to reverse the symptoms if severe.
Naloxone can precipitate withdrawal.
Despite being extremely uncomfortable for the patient, opiate withdrawal is not medically dangerous. Opiate withdrawal does not cause an altered sensorium or confusion but can contribute to agitation in patients with mental status changes occuring for other reasons. The scale should be scored hourly for the first 24 hours and then q 4 hours for 72 hours if stable. Always rate at least once prior to giving any medication to prophylax or treat withdrawal. The methadone dosage of patients on methadone maintenance must be confirmed with the patient's clinic.