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Evaluation and Treatment of the Suspected Drug User in the Emergency Room

Evaluation and Treatment of the Suspected Drug User in the Emergency Room Abstract In increasing numbers patients are coming to hospital emergency rooms with drug-related symptoms. Abuse of psychotropic agents has now spread to incidental abuse of nonpsychotropic agents as well, with the experimental self-administration of almost any chemical compound or consumer product which is available. It is even common for youngsters to ingest or inject an unknown agent in an attempt to flirt with the unexpected, in the manner that youngsters of earlier generations boarded a train without knowing the destination. Accordingly, there is an increasing awareness on the part of physicians of a need for more concise and accurate information pertaining to the diagnosis and treatment of the condition of the suspected drug user.1 This communication is designed to assist physicians staffing the emergency room area to appreciate current concepts of the evaluation and treatment of the suspected drug user. Commonly Abused Drugs It is understandable that most drugs abused References 1. Louria, D.B.: Medical Complications of Pleasure-Giving Drugs , Arch Intern Med 123:82-87 ( (Jan) ) 1969.Crossref 2. Jelliffe, R.W., et al: Death From Weight-Control Pills: A Case Report With Objective Postmortem Confirmation , JAMA 208:1843-1847 ( (June 9) ) 1969.Crossref 3. Goodman, L.S., and Gilman, A. (eds.): The Pharmacological Basis of Therapeutics , ed 3, New York: Macmillan Co., 1965, p 983. 4. Sollmann, T.: A Manual of Pharmacology and Its Applications to Therapeutics and Toxicology , ed 8, Philadelphia: W. B. Saunders Co., 1957, pp 160-161. 5. Putnam, P.L., and Ellinwood, E.H., Jr.: Narcotic Addiction Among Physicians: A Ten-Year Follow-up , Amer J Psychiat 122:745-748 ( (Jan) ) 1966. 6. Frosch, W.A.; Robbins, E.S.; and Stern, M.: Untoward Reactions to Lysergic Acid Diethylamide (LSD) Resulting in Hospitalization , New Eng J Med 273:1235-1239 ( (Dec 2) ) 1965.Crossref 7. Cohen, S.: Suicide Following Morning Glory Seed Ingestion , Amer J Psychiat 120:1024-1025 ( (April) ) 1964. 8. Keeler, M.H.; Reifler, C.B.; and Liptzin, M.B.: Spontaneous Recurrence of Marihuana Effect , Amer J Psychiat 125:384-386 ( (Sept) ) 1968. 9. Smith, D.E.: Acute and Chronic Toxicity of Marihuana , J Psychedelic Drugs 2:37-47 ( (Fall) ) 1968.Crossref 10. Dependence on LSD and Other Hallucinogenic Drugs, Council on Mental Health and Committee on Alcoholism and Drug Dependence , JAMA 202: 47-50 ( (Oct 2) ) 1967. 11. Snyder, S.H.; Faillace, L.; and Hollister, L.: 2,5 Dimethoxy-4-Methyl Amphetamine (STP): A New Hallucinogenic Drug , Science 158:669-670 ( (Nov 3) ) 1967.Crossref 12. Szara, S.: The Hallucinogenic Drugs—Curse or Blessing? Amer J Psychiat 123:1513-1518 ( (June) ) 1967. 13. Aberle, D.F.: The Peyote Religion Among the Navaho , Chicago: Aldine Publishing Co., 1966. 14. Fink, P.J.; Goldman, M.J.; and Lyons, I.: Recent Trends in Substance Abuse: Morning Glory Seed Psychosis , Int J Addictions 2:143-151 ( (Spring) ) 1967. 15. Keeler, M.H., and Kane, F.J., Jr.: The Use of Hyoscyamine As a Hallucinogen and Intoxicant , Amer J Psychiat 124:852-854 ( (Dec) ) 1967. 16. Schultes, R.E.: Hallucinogens of Plant Origin , Science 163:245-254 ( (Jan 17) ) 1969.Crossref 17. Press, E., and Done, A.K.: Solvent Sniffing. Pediatrics 39:451-461 ( (March) ) 18. 611-622 (April) 1967. 19. Glaser, F.B.: Inhalation Psychosis and Related States , Arch Gen Psychiat 14:315-322 ( (March) ) 1966.Crossref 20. Keeler, M.H.: Adverse Reaction to Marihuana , Amer J Psychiat 124:674-677 ( (Nov) ) 1967. 21. Smith, D.E.: " Acute and Chronic Toxicity of Marihuana ," in D. E. Smith (ed.): Drug Abuse Papers 1969, Continuing Education in Criminology , Berkeley, Calif: University of California, 1969. 22. Efron, D.H. (ed.): " Marihuana: A Few Problems ," in Psychopharmacology, A Review of Progress, 1957-1967 , publication 1836, Public Health Service, 1968, pp 1269-1271. 23. Louria, D.B.; Hensle, T.; and Rose J.: The Major Medical Complications of Heroin Addiction , Ann Intern Med 67:1-22 ( (July) ) 1967.Crossref 24. Weil, A.T.; Zinberg, N.E.; and Nelson, J.M.: Clinical and Psychological Effects of Marihuana in Man , Science 162:1234-1242 ( (Dec 13) ) 1968.Crossref 25. Essig, C.F.: Newer Sedative Drugs That Can Cause States of Intoxication and Dependence of Barbiturate Type , JAMA 196:714-717 ( (May 23) ) 1966.Crossref 26. Fisher, D.D., and Ungerleider, J.T.: Grand Mal Seizures Following Ingestion of LSD-25 , Calif Med 106:210-211 ( (March) ) 1967. 27. Logothetis, J.: Spontaneous Epileptic Seizures and Electroencephalographic Changes in the Course of Phenothiazine Therapy , Neurology 17:869-877 ( (Sept) ) 1967.Crossref 28. Jenis, E.H.; Payne, R.J.; and Goldbaum, L.R.: Acute Meprobamate Poisoning: A Fatal Case Following a Lucid Interval , JAMA 207:361-362 ( (Jan 13) ) 1969.Crossref 29. Kelley, W.N., et al: Acetazolamide in Phenobarbital Intoxication , Arch Intern Med 117:64-69 ( (Jan) ) 1966.Crossref 30. Chazan, J.A., and Cohen, J.J.: Clinical Spectrum of Glutethimide Intoxication: Hemodialysis Reevaluated , JAMA 208:837-839 ( (May 5) ) 1969.Crossref 31. Maher, J.F., and Schreiner, G.E.: The Dialysis of Poisons and Drugs , Trans Amer Soc Artif Intern Organs 14:440-453, 1968. 32. Blachly, P.H.: Management of the Opiate Abstinence Syndrome , Amer J Psychiat 122:742-744 ( (Jan) ) 1966. 33. Blachly, P.H.: Procedure For Withdrawal of Barbiturates , Amer J Psychiat 120:894-895 ( (March) ) 1964. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Evaluation and Treatment of the Suspected Drug User in the Emergency Room

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References (33)

Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1970.00310010164022
Publisher site
See Article on Publisher Site

Abstract

Abstract In increasing numbers patients are coming to hospital emergency rooms with drug-related symptoms. Abuse of psychotropic agents has now spread to incidental abuse of nonpsychotropic agents as well, with the experimental self-administration of almost any chemical compound or consumer product which is available. It is even common for youngsters to ingest or inject an unknown agent in an attempt to flirt with the unexpected, in the manner that youngsters of earlier generations boarded a train without knowing the destination. Accordingly, there is an increasing awareness on the part of physicians of a need for more concise and accurate information pertaining to the diagnosis and treatment of the condition of the suspected drug user.1 This communication is designed to assist physicians staffing the emergency room area to appreciate current concepts of the evaluation and treatment of the suspected drug user. Commonly Abused Drugs It is understandable that most drugs abused References 1. Louria, D.B.: Medical Complications of Pleasure-Giving Drugs , Arch Intern Med 123:82-87 ( (Jan) ) 1969.Crossref 2. Jelliffe, R.W., et al: Death From Weight-Control Pills: A Case Report With Objective Postmortem Confirmation , JAMA 208:1843-1847 ( (June 9) ) 1969.Crossref 3. Goodman, L.S., and Gilman, A. (eds.): The Pharmacological Basis of Therapeutics , ed 3, New York: Macmillan Co., 1965, p 983. 4. Sollmann, T.: A Manual of Pharmacology and Its Applications to Therapeutics and Toxicology , ed 8, Philadelphia: W. B. Saunders Co., 1957, pp 160-161. 5. Putnam, P.L., and Ellinwood, E.H., Jr.: Narcotic Addiction Among Physicians: A Ten-Year Follow-up , Amer J Psychiat 122:745-748 ( (Jan) ) 1966. 6. Frosch, W.A.; Robbins, E.S.; and Stern, M.: Untoward Reactions to Lysergic Acid Diethylamide (LSD) Resulting in Hospitalization , New Eng J Med 273:1235-1239 ( (Dec 2) ) 1965.Crossref 7. Cohen, S.: Suicide Following Morning Glory Seed Ingestion , Amer J Psychiat 120:1024-1025 ( (April) ) 1964. 8. Keeler, M.H.; Reifler, C.B.; and Liptzin, M.B.: Spontaneous Recurrence of Marihuana Effect , Amer J Psychiat 125:384-386 ( (Sept) ) 1968. 9. Smith, D.E.: Acute and Chronic Toxicity of Marihuana , J Psychedelic Drugs 2:37-47 ( (Fall) ) 1968.Crossref 10. Dependence on LSD and Other Hallucinogenic Drugs, Council on Mental Health and Committee on Alcoholism and Drug Dependence , JAMA 202: 47-50 ( (Oct 2) ) 1967. 11. Snyder, S.H.; Faillace, L.; and Hollister, L.: 2,5 Dimethoxy-4-Methyl Amphetamine (STP): A New Hallucinogenic Drug , Science 158:669-670 ( (Nov 3) ) 1967.Crossref 12. Szara, S.: The Hallucinogenic Drugs—Curse or Blessing? Amer J Psychiat 123:1513-1518 ( (June) ) 1967. 13. Aberle, D.F.: The Peyote Religion Among the Navaho , Chicago: Aldine Publishing Co., 1966. 14. Fink, P.J.; Goldman, M.J.; and Lyons, I.: Recent Trends in Substance Abuse: Morning Glory Seed Psychosis , Int J Addictions 2:143-151 ( (Spring) ) 1967. 15. Keeler, M.H., and Kane, F.J., Jr.: The Use of Hyoscyamine As a Hallucinogen and Intoxicant , Amer J Psychiat 124:852-854 ( (Dec) ) 1967. 16. Schultes, R.E.: Hallucinogens of Plant Origin , Science 163:245-254 ( (Jan 17) ) 1969.Crossref 17. Press, E., and Done, A.K.: Solvent Sniffing. Pediatrics 39:451-461 ( (March) ) 18. 611-622 (April) 1967. 19. Glaser, F.B.: Inhalation Psychosis and Related States , Arch Gen Psychiat 14:315-322 ( (March) ) 1966.Crossref 20. Keeler, M.H.: Adverse Reaction to Marihuana , Amer J Psychiat 124:674-677 ( (Nov) ) 1967. 21. Smith, D.E.: " Acute and Chronic Toxicity of Marihuana ," in D. E. Smith (ed.): Drug Abuse Papers 1969, Continuing Education in Criminology , Berkeley, Calif: University of California, 1969. 22. Efron, D.H. (ed.): " Marihuana: A Few Problems ," in Psychopharmacology, A Review of Progress, 1957-1967 , publication 1836, Public Health Service, 1968, pp 1269-1271. 23. Louria, D.B.; Hensle, T.; and Rose J.: The Major Medical Complications of Heroin Addiction , Ann Intern Med 67:1-22 ( (July) ) 1967.Crossref 24. Weil, A.T.; Zinberg, N.E.; and Nelson, J.M.: Clinical and Psychological Effects of Marihuana in Man , Science 162:1234-1242 ( (Dec 13) ) 1968.Crossref 25. Essig, C.F.: Newer Sedative Drugs That Can Cause States of Intoxication and Dependence of Barbiturate Type , JAMA 196:714-717 ( (May 23) ) 1966.Crossref 26. Fisher, D.D., and Ungerleider, J.T.: Grand Mal Seizures Following Ingestion of LSD-25 , Calif Med 106:210-211 ( (March) ) 1967. 27. Logothetis, J.: Spontaneous Epileptic Seizures and Electroencephalographic Changes in the Course of Phenothiazine Therapy , Neurology 17:869-877 ( (Sept) ) 1967.Crossref 28. Jenis, E.H.; Payne, R.J.; and Goldbaum, L.R.: Acute Meprobamate Poisoning: A Fatal Case Following a Lucid Interval , JAMA 207:361-362 ( (Jan 13) ) 1969.Crossref 29. Kelley, W.N., et al: Acetazolamide in Phenobarbital Intoxication , Arch Intern Med 117:64-69 ( (Jan) ) 1966.Crossref 30. Chazan, J.A., and Cohen, J.J.: Clinical Spectrum of Glutethimide Intoxication: Hemodialysis Reevaluated , JAMA 208:837-839 ( (May 5) ) 1969.Crossref 31. Maher, J.F., and Schreiner, G.E.: The Dialysis of Poisons and Drugs , Trans Amer Soc Artif Intern Organs 14:440-453, 1968. 32. Blachly, P.H.: Management of the Opiate Abstinence Syndrome , Amer J Psychiat 122:742-744 ( (Jan) ) 1966. 33. Blachly, P.H.: Procedure For Withdrawal of Barbiturates , Amer J Psychiat 120:894-895 ( (March) ) 1964.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1970

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