Every substance tells the same story three times: what it looks like on board, what it looks like coming off, and which agent you reach for. Withdrawal is usually the mirror image of intoxication — and for two of these six, it can kill. Tap a substance, then switch phases.
Pick a substance
Pupils and vital signs are your fastest bedside clues.
Heart rate—
Resp rate—
BP—
Temp °C—
Six substancestap one to begin
Pupils are the fastest tellPinpoint points to opioids. Blown wide points to stimulants — or to opioid withdrawal. Normal pupils in a sedated patient point to alcohol or a benzodiazepine. Confirm with respiratory rate: opioids and sedatives drive it down, withdrawal drives it up.