Which of the following is an early symptom of opioid withdrawal?

Which of the following is an early symptom of opioid withdrawal?

• A. Nasal congestion.
• B. Restlessness.
• C. Abdominal cramping.
• D. Nausea.

Answer: (B)

Restlessness reflects the immediate CNS and autonomic hyperarousal that marks the start of opioid withdrawal. When opioids are no longer acting, the body’s adrenergic systems ramp up, leading to early neuropsychiatric symptoms such as restlessness and irritability, along with other autonomic signs like sweating and yawning. Nausea and abdominal cramping tend to appear later as withdrawal progresses and the GI tract becomes more reactive to the sudden loss of opioid input. While nasal symptoms like congestion can occur, restlessness is a characteristic early sign that typically accompanies the initial surge in withdrawal activity, making it the best choice for an early symptom.

Restlessness reflects the immediate CNS and autonomic hyperarousal that marks the start of opioid withdrawal. When opioids are no longer acting, the body’s adrenergic systems ramp up, leading to early neuropsychiatric symptoms such as restlessness and irritability, along with other autonomic signs like sweating and yawning. Nausea and abdominal cramping tend to appear later as withdrawal progresses and the GI tract becomes more reactive to the sudden loss of opioid input. While nasal symptoms like congestion can occur, restlessness is a characteristic early sign that typically accompanies the initial surge in withdrawal activity, making it the best choice for an early symptom.