Substance Abuse

Dec 1, 2000 Issue
Gamma-Hydroxybutyrate (GHB): A Newer Drug of Abuse [Article]

Gamma-hydroxybutyrate (GHB) is an illicitly marketed substance that has recently gained popularity among body builders and party attendees as a drug of abuse. GHB is a depressant that acts on the central nervous system. It is purported as a strength enhancer, euphoriant and aphrodisiac and is one of...

May 1, 2000 Issue
An Approach to Drug Abuse, Intoxication and Withdrawal [Article]

The symptomatic effects of drug abuse are a result of alterations in the functioning of the following neurotransmitters or their receptors: acetylcholine, dopamine, gamma-aminobutyric acid, norepinephrine, opioids and serotonin. Anticholinergic drugs antagonize acetylcholine receptors. Dissociative ...

Apr 15, 2000 Issue
Addiction: Part II. Identification and Management of the Drug-Seeking Patient [Article]

The medications most often implicated in prescription drug abuse are opioid analgesics, sedative-hypnotics and stimulants. Patients with acute or chronic pain, anxiety disorders and attention-deficit disorder are at increased risk of addiction comorbidity. It is important to ask patients about their...

Apr 1, 2000 Issue
Addiction: Part I. Benzodiazepines-Side Effects, Abuse Risk and Alternatives [Article]

Benzodiazepines are widely prescribed for a variety of conditions, particularly anxiety and insomnia. They are relatively safe and, with overdose, rarely result in death. However, used chronically, benzodiazepines can be addicting. These agents are often taken in combination with other drugs of abus...

Dec 01, 1999 Issue
Marijuana: Medical Implications [Article]

Over 50 percent of people will use marijuana sometime in their life. While intoxication lasts two to three hours, the active ingredient in marijuana, delta-9-tetrahydro-cannabinol, can accumulate in fatty tissues, including the brain and testes. Adverse effects from marijuana use include decreased c...

Dec 01, 1999 Issue
Is My Colleague Overprescribing Narcotics? [Curbside Consultation]

Physicians regularly face the ethical dilemma of determining whether the prescribing habits of a colleague are appropriate, and must then decide how to deal with that person. Such situations can engender hostility and resentment among colleagues and are rarely easily handled.

Sep 15, 1999 Issue
Outpatient Detoxification of the Addicted or Alcoholic Patient [Article]

Outpatient detoxification of patients with alcohol or other drug addiction is being increasingly undertaken. This type of management is appropriate for patients in stage I or stage II of withdrawal who have no significant comorbid conditions and have a support person willing to monitor their progres...

Jul 01, 1998 Issue
Management of Withdrawal Syndromes and Relapse Prevention in Drug and Alcohol Abuse [Article]

The primary care physician is in a good position to diagnose, manage and intervene with patients who are undergoing the process of treatment and recovery from alcohol and drug disorders. Medications such as benzodiazepines are effective in the treatment of withdrawal syndromes, and naltrexone and di...

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