Suitability for GP withdrawal management includes:

• mild to moderate withdrawal predicted and no medical/psychiatric contraindications
• where patient wants it and will comply with instructions
• where the GP is able, willing and available (daily review)
• where carer support is available (to look after the patient, dispense medication and call for help if deterioration)
• where the patient is able to arrange their responsibilities and commitments to give themselves a period of minimal stress and sufficient time for withdrawal.

Intensive inpatient care is appropriate with:

• unstable medical or psychiatric condition
• poly-drug dependence
• a history of medical or psychiatric conditions or uncertain past drug use indicating a need for close monitoring
• a history of complicated alcohol withdrawal (seizures or delirium)
• a history of seizures associated with benzodiazepine withdrawal.

Supported residential care, such as a community withdrawal unit, is appropriate if:

• there is an unsupportive home environment, such as with other drug users, or without anyone reliable to supervise and support the patient
• there has been repeated failure at outpatient withdrawal.

Withdrawal management focuses on:

• prevention of severe withdrawal
• reducing the risk of injury (self/others) due to altered mental state
• reducing the risk of dehydration, electrolyte and nutritional imbalance
• preventing seizures
• identification and treatment of concurrent medical conditions that can mask or mimic withdrawal or complicate the withdrawal process.

For detailed information visit the Alcohol Withdrawal Management page on the SA Health website.

Amphetamine withdrawal is largely subjective, but may be difficult to manage, particularly for friends and family members, due to mood swings.

An inpatient setting may be necessary if the patient has significant psychotic symptoms, in which case a referral to mental health services is appropriate.

For further details visit the Amphetamine Withdrawal Management page on the SA Health website.

The onset and duration of symptoms varies depending on the particular benzodiazepine/s taken as there is a wide variation in half-life and some benzodiazepines have active metabolites.

For further information visit the Benzodiazepine Withdrawal Management page on the SA Health website.

Withdrawal symptoms are variable and may not relate to the quantity smoked or duration of use. Most common symptoms comprise:

• craving
• anxiety, restlessness, irritability
• anorexia (and weight loss)
• disturbed sleep and vivid dreams
• gastrointestinal tract symptoms (eg abdominal pain)
• night sweats
• tremor.

Symptoms may last one to two weeks. There are no significant complications of withdrawal that would necessitate inpatient treatment.

For further information visit the Cannabis Withdrawal Management page on the SA Health website.

Features of GHB (Gamma Hydroxyl Butyric Acid) withdrawal are similar to alcohol withdrawal. Withdrawal severity varies considerably from mild through to severe and will relate to the amount used. A small number of clients may develop delirium and psychotic features, sometimes needing intensive care.

For more information including medication regimes visit the GHB Withdrawal Management page on the SA Health website.

Withdrawal symptoms are similar for all opioids, but are of varying severity and duration depending on opioid taken. For example, physical symptoms of heroin withdrawal commence six to 12 hours after last use and last for approximately five days. Symptoms are very unpleasant, but are rarely life-threatening (providing adequate hydration and electrolyte balance is maintained).

For more information including medication regimes visit the Opioid Withdrawal Management page on the SA Health website.