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Self-Assessment Questions


Psychiatry


Answer 1
  1. Heroin addiction/dependence. Opiate withdrawal is characterized by either the recent reduction in heavy or prolonged opiate use or the administration of an opioid antagonist after a period of opioid use, functional impairment, and 3 or more of the following symptoms: dysphoric mood; nausea or vomiting; muscle aches; lacrimation or rhinorrhea; pupillary dilation, piloerection, or sweating; diarrhea; yawning; fever; or insomnia. Although food poisoning or influenza can present as the symptoms above, these diagnoses would not explain the urine drug screen results. Morning sickness from pregnancy is possible but would not fully account for the patient’s symptoms. Although the patient could be in withdrawal from her prescribed oxycodone and acetaminophen, these medications have not been prescribed long enough to be a likely cause of her withdrawal. The presence of 6-monoacetylmorphine can only be attributed to heroin, an illegal drug of abuse.

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