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  • Cited by 3
  • Print publication year: 2007
  • Online publication date: December 2009

9 - Drug misuse in medical patients

from Part II - Common psychiatric problems across the general hospital


This chapter concentrates on illicit drugs and the misuse of prescribed medication. The more serious the substance problem, the more likely there are to be associated psychological, physical and social problems, which require a more intensive level of treatment intervention. Psychiatric disorders such as depression, anxiety, psychosis, eating disorders, and post-traumatic stress disorders are associated with the direct intoxicating effects of acute and chronic substance misuse and withdrawal syndromes, often within an inhospitable social environment. There is an increased risk of traumatic injury resulting in hospitalization among substance users. An awareness of and a high index of suspicion about drug use must pervade all aspects of practice, especially assessment. Pharmacotherapy is available for opiates, alcohol and nicotine. Substance users are heterogeneous, no single approach is universally effective, and evaluation of treatment outcome should be multidimensional.

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