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Citation |
Fogarty A, Lingford-Hughes A. Medicine (Abingdon) 2004; 32(7): 29-33. |
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Copyright |
(Copyright © 2004, Medicine Publishing) |
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DOI |
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PMID |
unavailable |
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Abstract |
Licit and illicit substance misuse represents a significant burden to the individual and to society as a whole. Recognition of harmful substance use can lead to early and effective intervention at the primary-care level. Many cases continue to be missed, leading to late presentation when the chronic complications of substance misuse are already present. This contribution describes the level at which alcohol consumption becomes misuse, and how to recognize and assess harmful levels. Alcohol is associated with many medical and psychiatric emergencies, and has chronic effects that often remain undetected for some time. There are several pharmacological and psychosocial interventions to manage detoxification, change drinking behaviour and maintain abstinence. Illicit substances of abuse such as opioids and stimulants are also described. Opioid substitution or maintenance is a widely available treatment aimed at reducing illicit use and its associated problems (e.g. sharing needles, crime to fund the user's habit). The mainstay of treatment of illicit substance misuse is psychosocial, but pharmacotherapy has an important role in opioid stabilization, maintenance and detoxification. The sign and symptoms commonly seen in acute intoxication and withdrawal are described, in addition to the chronic effects of a wide range of substances of abuse. |