Stimulant withdrawals- assessment help

[Indy, LPN, LVN]

Hi, I work on a cardiac/telemetry unit. I've noticed we have at least one crack or meth user per week on my unit, which gives me about a 25% chance to have one as a patient at any given time.

Most of them aren't really symptomatic, or they have appropriate orders in case of withdrawals. Some, like my guy from tuesday night, are very symptomatic AND they were admitted by a certain ER doc who wrote for lortab and that's it. Which is fine for the headache before the withdrawals, but don't do diddly during the acute phase.

So, went back to my psych textbook today. The CIWA isn't in there, looked it up online, it says it's for alcohol withdrawals. I'm pretty certain it was used across the board at the hospital where we did psych clinicals. There's this other thing I found, the Hamilton Anxiety Scale.

I want some tool to use when I have to call the hospitalist for NOW orders for a withdrawal patient. I don't wanna call like I did Wed. morning and say "so and so is in full-blown DT's," although that may be the case, if I get a certain doc, I'm gonna get orders for something like toradol or "I don't want to feed his addiction" comments. Any ideas on which scale I should use? I will put the CIWA in my bag for alcohol withdrawals, but stimulant withdrawals are more concerning to me right now.

[Indy, LPN, LVN]

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