Sedative hypnotic withdrawal
- Early sedative-hypnotic withdrawal symptoms are similar to opioid withdrawal: agitation, anxiety, increased vital signs, tremors, and gastrointestinal distress
- As withdrawal develops further, symptoms of untreated or undertreated sedative-hypnotic withdrawal are more severe and may be life-threatening (eg, seizures, cardiovascular instability and collapse, coma) compared with opioid withdrawal
- History of sustained sedative-hypnotic use (eg, alcohol, benzodiazepines, barbiturates) and/or urine drug screening that supports use of sedative-hypnotics helps to differentiate from opioid withdrawal; additionally, benzodiazepines will suppress withdrawal from sedative-hypnotics, whereas opioids will not
- Do not use a single positive urine drug screen alone to support the diagnosis of sedative-hypnotic (or other drug) withdrawal because a screen could be positive after single use of a drug; watch for withdrawal symptoms as well
