Intoxication vs Withdrawal: What Nurses Do First

This episode explains the differences among intoxication, withdrawal, physical dependence, addiction, and substance use disorder. It then applies those concepts to alcohol, opioids, and stimulants so you can connect vital signs, pupil changes, behavior, timing, and patient history with the right nursing priorities. 👉 Watch the video on Super Nurse Comics 👉 Visit https://supernurse.ai for more practical nursing resources. You'll learn - Why intoxication and withdrawal often produce opposite clinical patterns - Early and severe signs of alcohol withdrawal, including seizures and delirium tremens - How CIWA scoring guides assessment and symptom-triggered treatment - Why benzodiazepines, thiamine, fluids, seizure precautions, and a low-stimulation environment may be anticipated - How opioid intoxication differs from opioid withdrawal—and why airway and respiratory status come first during overdose - Why stimulant withdrawal requires close mental health and suicide-risk monitoring - Warning signs of medication diversion or impairment in a healthcare professional - Why asking about the patient's last drink or dose creates a crucial bedside timeline Chapters 00:00 The bedside clues that can look like deterioration 01:32 Substance abuse and addiction at the bedside 02:04 Intoxication, withdrawal, dependence, and addiction 03:44 How addiction changes the brain's reward system 04:56 Alcohol withdrawal signs and timeline 07:12 CIWA scoring and immediate nursing priorities 09:00 Benzodiazepines, thiamine, and Wernicke's encephalopathy 10:07 Opioid intoxication, withdrawal, and treatment 11:55 Stimulant intoxication, the crash, and suicide precautions 13:56 Substance use disorder and impairment among nurses 16:44 Bedside pattern recognition and what to ask first 18:02 Recognizing stigma and protecting clinical judgment This podcast is for educational purposes only and does not replace facility policy, clinical judgment, or medical advice. Follow your organization's protocols and consult the appropriate provider or emergency resources for patient-specific concerns. The content presented in The Super Nurse Podcast is for educational purposes only and should not be considered medical advice. The host and creators are not responsible for any clinical decisions made based on this content. Always adhere to your institution’s policies and consult appropriate healthcare professionals when making patient care decisions.