Complicated opioid withdrawal presenting with delirium

Unlike alcohol or benzodiazepine withdrawal, delirium is extremely uncommon during opioid withdrawal. We describe a case of smack addiction and opioid withdrawal in which led to delirium during withdrawal management. There is no prior history of substance misuse and no relevant personal or family background. It is discussed if delirium could be a withdrawal sign in opioid dependence. Yawning, sweating, lacrimation, rhinorrhea, anxiety, restlessness, insomnia, dilated pupils, piloerection, chills, tachycardia, hypertension, nausea/vomiting, crampy abdominal pains, diarrhea, and muscle aches and pains are some of the withdrawal symptoms that are typically associated with opioid abuse.