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Substance Abuse: Intoxication and Withdrawal 

Substance Abuse: Intoxication and Withdrawal
Chapter:
Substance Abuse: Intoxication and Withdrawal
Author(s):

Joe Kwon

, Emily Deringer

, and Luke Archibald

DOI:
10.1093/med/9780190250843.003.0007
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date: 12 December 2019

Substance use disorders are a common cause of presentations to the ED and a cause of psychiatric consultation. Recognizing or suspecting intoxication or withdrawal as a cause of a change in behavior, mood, or mental status is an important skill for the ED psychiatrist to possess. This chapter examines three common substances of abuse from the period of initial intoxication through early withdrawal. The first case describes a patient acutely intoxicated with alcohol with comorbid mood symptoms who then experiences early signs of withdrawal. The second case describes a patient with cocaine intoxication leading to psychosis and subsequent lethargy and dysphoria. The third case describes a woman with severe opiate dependence who relapsed after a period of sobriety, leading to overdose, who then becomes agitated when naloxone is administered. Other drugs of abuse that lead to ED presentations are also discussed.

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