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3.15.6 - Substance Misuse and Withdrawal in Intensive Care

from Section 3.15 - Psychiatric Disorders Encountered in Intensive Care

Published online by Cambridge University Press:  27 July 2023

By
Ruth Taylor  and
Peter Byrne
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. All patients should be considered at risk of withdrawal syndromes.

  2. 2. Prompt recognition and treatment are key to its management.

  3. 3. Treatment for withdrawal syndromes is generally supportive, alongside the use of benzodiazepines.

  4. 4. Alcohol withdrawal syndrome is a medical emergency, with 20 per cent mortality if untreated.

  5. 5. The specialist drugs team should be contacted for advice prior to the prescription of methadone.

Keywords

withdrawal syndromedelirium tremensopiatesmethadone
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 452 - 454
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Garimella, PS, Joffe, A, Velho, V. Street drug abuse leading to critical illness. Intensive Care Med 2004;30:1526–36.Google Scholar
Habal, R. 2016. Heroin toxicity treatment and management. emedicine.medscape.com/article/166464-treatmentGoogle Scholar
National Institute for Health and Care Excellence. 2019. Alcohol withdrawal management for acute admissions to hospital. www.nice.org.uk/sharedlearning/alcohol-withdrawal-management-for-acute-admissions-to-hospitalGoogle Scholar
Royal College of Physicians. 2012. Alcohol dependence and withdrawal in the acute hospital. www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospitalGoogle Scholar
Subramaniam, K, Gowda, RM, Jani, K, Zewedie, W, Ute, R. Case report: propofol combined with lorazepam for severe poly substance misuse and withdrawal states in intensive care unit: a case series and review. Emerg Med J 2003;21:632–4.Google Scholar
Tetrault, JM, O’Connor, PG. Substance abuse and withdrawal in the critical care setting. Crit Care Clin 2008;24:767–88, viii.CrossRefGoogle ScholarPubMed
World Health Organization. 2009. Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. www.ncbi.nlm.nih.gov/books/NBK310654/Google Scholar

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