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Drug Intoxication and Withdrawal: Signs and Symptoms Alcohol Intoxication • Recent ingestion of alcohol • Clinically significant maladaptive behavioral or psychological changes (e.g., inappropriate sexual or aggressive behaviors). • One or more the the following: – – – – Slurred speech Incoordination Unsteady gait Nystagmus -Impairment in attention or memory -Stupor or coma Alcohol Withdrawal • Cessation of (or reduction in) alcohol use that has been heavy and prolonged. • Two (or more) of the following: – – – – – – Autonomic hyperactivity (sweating, high pulse rate). Increased hand tremor -Anxiety Insomnia -Grand mal seizures Nausea/vomiting Psychomotor agitation Transient visual, tactile, or auditory hallucinations or illusions Sedative/Hypnotic/Anxioly tic Intoxication • Clinically significant maladaptive behavioral or psychological changes (e.g., mood lability, inappropriate sexual or aggressive behavior). • One or more of the following signs: – – – – Slurred speech -Incoordination Unsteady gait -Nystagmus Impairment in attention or memory Stupor or coma • Symptoms not due to GMC or other mental disorder Sedative/Hypnotic/Anx iolytic Withdrawal • Two or more of the following: – Autonomic hyperactivity (e.g. sweating or PR >100) – Increased hand tremor -Anxiety – Insomnia -Nausea or vomiting – Psychomotor agitation -Grand mal seizures – Transient visual, tactile, or auditory hallucinations or illusions Amphetamine Intoxication • Recent use of amphetamine • Clinically significant maladaptive behavioral or psychological changes (e.g., euphoria, hypervigilance). • 2 or more of the following: – Tachycardia or bradycardia – Perspiration or chills – Evidence of weight loss - Pupillary dilation - Nausea or vomiting -Elevated or lowered blood pressure Amphetamine Intoxication (Cont’d) – Psychomotor agitation or retardation – Muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias – Confusion , seizures, dyskinesias, dystonias, or coma – Not due to GMC or another mental disorder Amphetamine Withdrawal • Cessation of heavy amphetamine use • Dysphoric mood, and two or more of the following: – – – – – Fatigue Vivid, unpleasant dreams Insomnia or hypersomnia Increased appetite Psychomotor retardation or agitation • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning • Not due to GMC or other mental disorder Cocaine Intoxication • Clinically sig. maladaptive behavioral or psychological changes (e.g., euphoria, tension, etc.). • Two or more of the following: – – – – Tachycardia or bradycardia -Nausea or vomiting Pupillary dilation -Perspiration or chills Elevated or lowered blood pressure Evidence of weight loss Cocaine Intoxication (Cont’d) – Psychomotor agitation or retardation – Muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias – Confusion, seizures, dyskinesias, dystonias, or coma – Not due to GMC or other mental disorder Cocaine Withdrawal • Dysphoric mood and two or more of the following: – – – – – Fatigue Vivid unpleasant dreams Insomnia or hypersomnia Increased appetite Psychomotor retardation or agitation • Symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning • Symptoms not due to GMC or other mental disorder. Caffeine Intoxication • Recent consumption of caffeine • Five of the following signs: – – – – – – – – Restlessness Excitement Flushed face Gastrointestinal disturbance Rambling flow of thought or speech Tachycardia or cardiac arrhythmia Periods of inexhaustibility Psychomotor agitation -Nervousness -Insomnia -Diuresis -Muscle twitching Caffeine Intoxication (Cont’d) • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. • Symptoms are not the result of a GMC or other mental disorder. Nicotine Withdrawal • Daily use of nicotine for at least several weeks • Abrupt cessation of nicotine use followed within 24 hours by four or more of the following: – – – – – Dysphoric or depressed mood -Insomnia Irritability, frustration, or anger -Anxiety Difficulty concentrating -Restlessness Decreased heart rate Increased appetite or weight gain • Symptoms cause significant distress in functioning • Symptoms not due to GMC or other mental disorder Opioid Intoxication • Clinically significant maladaptive behavioral or psychological changes (e.g., dysphoria, impaired judgment, euphoria followed by apathy). • Pupillary constriction (or dilation due to anoxia from severe overdose) and at least one of the following: – Drowsiness or coma -Slurred speech – Impairment in attention or memory • Symptoms not due to GMC or other mental disorder Opioid Withdrawal • Three (or more) of the following: – – – – – Dysphoric mood -Nausea or vomiting Muscle aches -Lacrimation or rhinorrhea Diarrhea -Yawning Fever -Insomnia Pupillary dilation, piloerection, or sweating • Symptoms cause significant distress or impairment in functioning • Symptoms not due to GMC or other mental disorder Cannabis Intoxication • Recent use • Clinically significant maladaptive behavioral or psychomotor changes (e.g., euphoria, anxiety). • Two or more of the following signs: – – – – Conjunctival injection Increased appetite Dry mouth Tachycardia • Symptoms not due to GMC or other mental disorder Hallucinogen Intoxication • Clinically significant maladaptive behavior or psychomotor changes (e.g., paranoid ideation, fear of losing one’s mind). • Perceptual changes occurring in a state of full wakefulness and alertness (e.g., depersonalization, illusions, etc.). • Two or more of the following: – – – – Pupillary dilation Tachycardia Sweating palpitations -Blurring of vision -Tremors -Incoordination Hallucinogen Flashbacks • Re-experiencing one or more perceptual symptoms that were first experienced while intoxicated by a hallucinogen (e.g., flashes of color, positive afterimages). • Symptoms cause clinically significant distress or impairment • Symptoms are not due to a GMC or other mental disorder Inhalant Intoxication • Clinically significant maladaptive behavioral or psychological changes (e.g., belligerence, apathy, etc.) • Two or more of the following signs: – – – – – – – Dizziness Incoordination Unsteady gait Depressed reflexes Tremors Euphoria Stupor or coma -Nystagmus -Slurred speech -Lethargy -Psychomotor retardation -Generalized muscle weakness -Blurred vision or diplopia Phencyclidine Intoxication PCP • Clinically significant maladaptive behavioral changes (e.g., belligerence, impulsiveness, etc.) • Within an hour, two or more of the following: – – – – – Hypertension or tachycardia -Hyperacusis Ataxia -Dysarthria Muscle rigidity -Seizures or coma Numbness or diminished responsiveness to pain Vertical or horizontal nystagmus • Symptoms are not due to GMC or other mental disorder