Complicated opioid withdrawal- A case report

Vivek Kumar, Nimish Gupta


Although, anecdotal case reports are being published describing complicated opioid withdrawal e.g. seizure and delirium, various international classification system and standard textbooks do not mention about the complicated withdrawal like with alcohol. Interestingly, these complications reported from specific form of the opioid and specific geographical region. The case in this report presented with complicated opioid withdrawal like picture which later found to be due to medical condition. Hence, we report this case here to discuss various possibilities to be explored while dealing with the case of complicated opioid withdrawal.


Keywords: Opioid, Complicated withdrawal, Seizure, Delirium

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World Health Organization. International Classification of diseases, 10th Revision (ICD-10). World Health Organization, Geneva, 1992.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association, 2000.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5thed.). Arlington, VA: American Psychiatric Publishing, 2013.

Mondal SK, Borthakur B, Deka K, Dihingia S, Bhuyan DJ. Atypical presentation of opioid withdrawal, an effect of adulteration. BMC Infectious Diseases. 2012 May 4;12(1):1.

Aggarwal A, Choudhary S, Jiloha RC. Opioid Withdrawal Delirium. The Journal of neuropsychiatry and clinical neurosciences. 2011 Oct; 23(4):E37.

Parkar SR, Seethalakshmi R, Adarkar S, Kharawala S. Is this' complicated'opioid withdrawal? Indian journal of psychiatry. 2006 Apr 1;48(2):121.

Ghanem AEA; Bakary AAE; Hassan AA. Chemical additives of street heroin in Cairo. Mansoura J. Forensic Med. Clin. Toxicol. 2008 Jan;16(1):1-11.

Mattoo SK, Singh SM, Bhardwaj R, Kumar S, Basu D, Kulhara P. Prevalence and correlates of epileptic seizure in substance‐abusing subjects. Psychiatry and clinical neurosciences. 2009 Aug 1;63(4):580-2.

Hamilton RJ, Perrone J, Hoffman R. A descriptive study of an epidemic of poisoning caused by heroin adulterated with scopolamine. 2000;38(6):597-608.

Das PP, Grover S, Kumar S. Naltrexone-Precipitated Delirium. German J Psychiatry 2005;8:101-103.