Acute management of alcohol and other drug use

Abstract

Intoxication and withdrawal syndromes are common presentations in acute medicine. Good management is based on a comprehensive history, including a collateral one, and thorough examination looking for patterns of signs and symptoms, backed up by appropriate investigations. A collaborative, empathic and non-judgemental approach that recognizes the patient's distress, explains the goals of management and sets clear boundaries significantly reduces potential complications and improves outcomes. An understanding of the pharmacology and clinical effects of alcohol, benzodiazepines, opioids and stimulants is essential to accurately diagnose and manage patients who may not be able to give an accurate history.