Substance Withdrawal

ICD-10 code: F10.3 / F11.3 / F12.3 / F13.3 / F14.3 / F15.3 / F16.3 / F17.3

MEDICATION TREATMENT

Consult with a psychiatrist or specialised referral unit. Mild withdrawal states can be managed as an outpatient whereas more severe cases should be referred to the local casualty for medical stabilisation. Children under 6 years old should be referred immediately to casualty.

Alcohol, Benzodiazepines, Stimulants (Cocaine, Methamphetamine) and less commonly Cannabis/Mandrax withdrawal

Management of mild withdrawal:

• Diazepam, oral.
  • 6 - 14 years: 2 - 10 mg daily in 2 - 3 divided doses.
  • > 14 years: up to 20 mg daily in 2 - 3 divided doses.
  • Taper dose over 3 - 5 days.

Hallucinogens/Volatile solvents

No detoxification indicated.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition

Chapter 14: Child & Adolescent Psychiatry, 14.13 Substance Use Disorder,   14.13.3 Substance Withdrawal

Click here for  14.13.3.1 Alcohol Withdrawal

Click here for  14.13.3.2 Alcohol Withdrawal Delirium

Click here for  14.13.3.3 Opioid Withdrawal

Click here for  14.13.3.4 Stimulant/Methaqualone (Mandrax)/Cannabis Withdrawal

Click here for  14.13.3.5 Benzodiazepine Withdrawal