Substance abuse disorder

21. • 80-100 mg / 100 ml blood – intoxication
• 200-250mg - toxic
• 300 mg -lose
consciousness
• 500 mg - fatal

46. • TREATING DELIRIUM TREMENS : iv anti anxiety
medications and iv fluids,restrtaints
• TREATING SEIZURES : iv phenytoin(dilantin) along
with benzodiazepine (monitor BP, Phenytoin reduces
BP)
• PSYCHOSIS: (thiamine deficiency),injection of
thiamine
• OTHERS : 100mg thiamine twice daily for 3-
5days(followed by 6 months oral admn.
• Fluid and electrolyte balance
• Vitals monitoring, consciousness and orientation
• Symptomatic treatment
• Correction of hypothermia and acidosis
• Measures for trauma infection and GI bleeding

47. Inpatient treatment
• Delirium tremens
• Harm to self and others
• Failure to respond to treatment
• Co existing medical or psychiatric disorder
• Disruptive home environment
Treatment includes
• Physical examination and tests
• Psychiatric work up
• Detoxification
• On going treatment
• Psychotherapy
• Introduction to AA

48. Outpatient treatment
• Medications
• Psychotherapy or counselling
• Social support groups (AA)
• Family involvement in patient care
Medications
• Naltrexone
• Acamprosate
• Disulfiram
• Others (antidepressants,)

50. • Anti-Craving Medications Inhibit dopamine release
by alcohol
• ↓ Pleasurable effects of alcohol
• ↓ Craving & urge to drink
• Example: naltrexone (Revia)
• Injectable long-acting naltrexone: Vivitro