[The medicine and drug-abusing patient]

Area of Science:

• Anesthesiology
• Pharmacology
• Pain Management

Background:

• Opioids and benzodiazepines are commonly prescribed for chronic pain and legal indications, respectively.
• Both substance classes carry risks of addiction and misuse, necessitating careful management.
• The emergence of novel illicit sedatives and psychoactive drugs complicates patient care.

Purpose of the Study:

• To provide perioperative management guidelines for patients using or misusing opioids and benzodiazepines.
• To address the challenges posed by newly introduced illicit substances in surgical settings.
• To ensure patient safety and optimize outcomes during the perioperative period.

Main Methods:

• Literature review of current guidelines and evidence on perioperative management of substance use.
• Analysis of risks associated with opioids, benzodiazepines, and illicit drugs in surgical patients.
• Development of practical recommendations for anesthesiologists and surgical teams.

Main Results:

• Identification of key considerations for managing patients with opioid and benzodiazepine dependence or misuse.
• Highlighting the importance of recognizing and managing exposure to novel illicit substances.
• Emphasis on multidisciplinary approaches for comprehensive patient care.

Conclusions:

• Perioperative care requires tailored strategies for patients using opioids, benzodiazepines, and illicit drugs.
• Proactive management and awareness of substance use patterns are crucial for patient safety.
• Guidelines are essential to navigate the complexities of managing these patients effectively.