Table 6.

Opioid withdrawal syndrome—symptoms to ask about as part of the addiction history and timing after opioid cessation

Addiction History—Opioid Withdrawal Syndrome Symptoms	Timing of Predicted Opioid Withdrawal Syndrome
• Nausea	Onset of symptoms
• Vomiting	• 6–12 h after last dose of short-acting opioid a
• Diarrhea	• 24–48 h after last dose of long-acting opioid b
• Sweating	Peak symptoms
• Irritability	• 24–48 h after onset
• Restlessness	Symptoms subside
• Tremor	Days to weeks (short-acting vs long-acting, respectively)
•Yawning

^aShort-acting opioids: morphine, codeine, hydromorphone, oxycodone, hydrocodone, diacetylmorphine (heroin), meperidine, tramadol, and fentanyl.

^bLong-acting opioid: methadone.