Fultz and Senay used a grading scheme for hospitalized patients undergoing opiate withdrawal. This was used to help guide initial methadone therapy. The authors are from Chicago, Illinois.
Physical Findings
Grade
lacrimation and/or rhinorrhea
diaphoresis
yawning
restlessness
insomnia
1
dilated pupils
piloerection
muscle twitching and/or myalgia
arthralgias
abdominal pain
2
tachycardia
hypertension
tachypnea
fever
anorexia or nausea
extreme restlessness
3
diarrhea and/or vomiting
dehydration
hyperglycemia
hypotension
curled-up position
4
The grade can be used to determine the initial dose of methadone to be used (5 mg for each Grade).
Grade
Initial Dose of Methadone
1
5 mg
2
10 mg
3
15 mg
4
20 mg
Limitations:
• The scheme was published in 1975.
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