Which of the following is a typical sign of opiate withdrawal?

• A. Yawning and sweating with increased heart rate
• B. Constricted pupils and bradycardia
• C. Lethargy and hypoventilation
• D. Hyperreflexia and agitation

Answer: (A)

Opioid withdrawal causes a surge of autonomic activity as the body reacts to the absence of opioids. The most telling signs are yawning, sweating, and a fast heart rate, reflecting sympathetic arousal and the body's attempt to reset on withdrawal. Yawning is particularly characteristic and often one of the earliest signs, while sweating and tachycardia accompany the overall autonomic storm.

Constricted pupils and a slow heart rate point toward opioid effects or overdose, not withdrawal, so those features don’t fit the withdrawal pattern. Lethargy and hypoventilation signal CNS depression from intoxication rather than withdrawal, which is typically marked by agitation rather than sedation. Hyperreflexia and agitation aren’t classic for opioid withdrawal; agitation can occur, but hyperreflexia is not a defining sign.