from extreme agitation to coma; slurred speech
Mood swings, lack of motivation, aggression, combativeness (related togeneral “disinhibiting” effect of the drug, loss of impulse control), dysphoricmood (withdrawal) Temporary psychosis with acute onset of auditory hallucinations and paranoiddelusions (unexplained neuropsychiatric presentation may be indicative of druguse)Psychomotor activity may be increasedHypersensitivity (e.g., anxiety, tremors, hypotension, irritability, restlessness, andseizure activity)Pupils small
pinpoint constriction (opiates), dilated (barbiturates); reaction to lightslowed; horizontal gaze, nystagmus, lack of convergenceGait unsteady
staggering, loss of coordination, positive Romberg’s sign
Headache, abdominal pain
severe crampingMuscle achesDeep muscle
bone pain (methadone abusers)
Continuous rhinorrhea, excessive lacrimation, sneezingRespiratory depression (overdose)Increased respiratory rate (withdrawal syndrome)
cold flashes; diaphoresis Thermoregulation instability with hyperpyrexia, hypothermia possible
Piloerection (“gooseflesh”); puncture wounds on arms, hands, legs, undertongue, indicating injection drug use
Dysfunctional family of origin systemDysfunctional patterns of interaction with family
psychological conditionsFamily history of substance use
abuseHistory of chronic condition
disease processConcurrent use of other drugs, including alcohol
Identifies drug(s) being used.
To determine presence of HIV, hepatitis B, etc.
Other Screening Studies:
Depend on general condition, individual risk factors, andcare setting.
Addiction Severity Index (ASI):
Produces a problem-severity profile, whichindicates areas of treatment needs.