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Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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Substance-Use Disorders in Critically Ill Patients: A Narrative Review.

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Area of Science:

  • Critical care medicine
  • Public health
  • Addiction medicine

Background:

  • Substance-use disorders (SUDs) are a significant public health concern with increasing prevalence.
  • More patients with SUDs are admitted to intensive care units (ICUs), either for SUD-related conditions or as a comorbidity.
  • Critical care providers require knowledge of SUDs to manage complex patient cases.

Purpose of the Study:

  • To review the epidemiology of substance use in critically ill patients.
  • To discuss the identification and treatment of common intoxication and withdrawal syndromes.
  • To provide evidence-based recommendations for managing critically ill patients with SUDs.

Main Methods:

  • Literature review focusing on substance use in critical care settings.
  • Analysis of epidemiological data related to SUDs in ICUs.
  • Synthesis of current evidence for managing intoxication, withdrawal, and chronic substance use effects.

Main Results:

  • SUDs complicate critical illness management due to intoxication, withdrawal, and chronic use sequelae.
  • Effective management requires understanding the unique challenges posed by SUDs in the ICU.
  • Specific recommendations are provided for addressing various aspects of SUDs in critical care.

Conclusions:

  • Critical care providers must be equipped to manage patients with substance-use disorders.
  • Addressing intoxication, withdrawal, and chronic effects is crucial for optimal patient outcomes.
  • This review offers a framework for evidence-based care of critically ill patients with SUDs.