5
Table 2. Common Signs of Opioid Intoxication and Withdrawal
Intoxication Signs Withdrawal Signs
• Drooping eyelids
• Constricted pupils
• Reduced respiratory rate
• Scratching (due to histamine release)
• Head nodding
• Restlessness, irritability, anxiety
• Insomnia
• Yawning
• Abdominal cramps, diarrhea, vomiting
• Dilated pupils
• Sweating
• Piloerection
Table 3. Related Physical Exam Findings in Substance Use
Disorders
System Findings
Dermatologic Abscesses, rashes, cellulitis, thrombosed veins, jaundice,
spider angioma, palmer erythema, scars, track marks, pock
marks from skin popping
Ear, nose, throat and
eyes
Pupils pinpoint or dilated, yellow sclera, conjunctivitis,
ruptured eardrums, otitis media, discharge from ears,
rhinorrhea, rhinitis, excoriation or perforation of nasal
septum, epistaxis, sinusitis, hoarseness, or laryngitis
Mouth Poor dentition, gum disease, abscesses
Cardiovascular Murmurs, arrhythmias
Respiratory Asthma, dyspnea, rales, chronic cough, hematemesis
Musculosketetal and
extremeties
Pitting edema, broken bones, traumatic amputations, burns
on fingers
Gastrointestinal Hepatomegaly, hernias
