All of the following are symptoms of opiate abuse withdrawal (COWS) except

A. "Your friends will understand when you tell them." This response, while well-meaning, may minimize the victim's feelings and pressure them to disclose something they might not be ready to share. It does not directly address the immediate emotional crisis the victim is experiencing.
B. "Are you thinking of suicide?" This is the most important response, as it directly addresses the risk of self-harm or suicide, which is a critical concern for victims of violent trauma, especially after a violent assault. The victim's statement, "There is no sense of trying to go on," may indicate feelings of hopelessness or despair, which are warning signs for suicidal ideation. It is essential to assess for any thoughts of suicide immediately to ensure the patient's safety.
C. "It will take time, but you will feel the same as before." While this response is intended to provide reassurance, it is unrealistic and does not acknowledge the trauma and emotional distress the victim is experiencing. Recovery from such an event is complex and often involves long-term emotional and psychological adjustments.
D. "You will be able to find meaning in this experience as time goes on." This response may sound dismissive and may not resonate with the victim at this time. Finding meaning can be part of the healing process later, but this statement may feel like an oversimplification or invalidation of the victim's current emotions.

A. Visual hallucinations can occur during alcohol withdrawal, especially in more severe cases such as delirium tremens (DTs). Hallucinations are part of the neuropsychiatric symptoms seen in alcohol withdrawal.
B. Tremors are one of the most common symptoms of alcohol withdrawal. Hand tremors are typically observed and can range from mild to severe.
C. Paroxysmal sweating (or excessive sweating) is also a common symptom of alcohol withdrawal. It occurs due to autonomic instability in the body during withdrawal, and can be quite pronounced.
D. Pupil dilation is not typically a symptom of alcohol withdrawal. In fact, alcohol withdrawal more commonly causes pupil constriction in mild to moderate withdrawal, and pupillary changes are generally less pronounced than other symptoms like tremors, sweating, or anxiety.