Clinical guidelines and procedures for the use of methadone in the maintenance treatment of opioid dependence

Appendix 2: Assessment of intoxication with methadone and other drugs

Page last updated: August 2003

Acute intoxication states from commonly used drugs
Signs and symptoms to look for / enquire about

Acute intoxication states from commonly used drugs

Opioids

(eg methadone, heroin, morphine)

Signs of intoxication:
  • Constriction of pupils
  • Itching/scratching
  • Sedation/somnolence
  • Lowered blood pressure
  • Slowed pulse
  • Hypoventilation
Signs of overdose:
  • Loss of consciousness
  • Respiratory depression
  • Pinpoint pupils
  • Hypotension
  • Bradycardia
  • Pulmonary oedema

Alcohol

Signs of intoxication:
  • Relaxation
  • Disinhibition
  • Impaired coordination
  • Impaired judgement
  • Decreased concentration
  • Slurred speech
  • Ataxia
  • Vomiting
Top of pageSigns of overdose:
  • Disorientation/confusion
  • Respiratory depression
  • Loss of consciousness
  • Loss of bladder control

Benzodiazepines

(eg diazepam, oxazepam, flunitrazepam)

Signs of intoxication:
  • Disinhibition
  • Sedation
  • Drooling
  • Incoordination
  • Slurred Speech
  • Lowered blood pressure
  • Dizziness
Signs of overdose:
  • Stupor/coma
  • Ataxia
  • Confusion
  • Respiratory depression

Stimulants

(eg amphetamines, cocaine)

Signs of intoxication:
  • Hyperactivity
  • Restlessness
  • Agitation
  • Anxiety/nervousness
  • Great dilation of pupils
  • Elevated blood pressure
  • Increased pulse
  • Raised temperature
  • Sweating
  • Tremor
Top of pageSigns of overdose:
  • Panic
  • Acute paranoid psychosis
  • Seizures
  • Cardiac arrhythmias
  • Myocardial ischaemia
  • Hypertensive crisis
  • Cerebrovascular accidents
  • Hyperpyrexia
  • Dehydration

Cannabis

Signs of intoxication:
  • Relaxation
  • Decreased concentration
  • Decreased psychomotor performance
  • Impaired balance
  • Conjunctival injection
Signs of overdose:
  • Paranoid psychosis
  • Confusion
  • Agitation
  • Anxiety/panic
  • Hallucinations

Signs and symptoms to look for / enquire about

Signs of intoxication:
  • Slurred speech
  • Unsteady gait
  • Drowsiness
  • Pupil constriction
  • Conjunctival injection
  • Alcoholic foetor
  • Disinhibition
  • Drooling
  • Dizziness
  • Itching/scratching
Top of pageSigns of toxicity:
  • Drowsiness
  • Shallow breathing
  • Poor circulation
  • Slow pulse
  • Lowered temperature
  • Nausea and vomiting
  • Headache
  • Confusion

From NSW Methadone Maintenance Treatment Clinical Practice Guidelines. Used with permission.