Withdrawal EmergentRecurrent Manic Episodes with Use of "Bhukki": A Case Report E vidence suggests a strong association between all mood disorders and substance use disorders. This association has been reported to be threefold to fourfold higher for opioid use disorders compared to other substances. 1 Both opioids-induced and withdrawal emergent mania are not reported frequently and, therefore, less understood. While the opioid most commonly related to induced mania is tramadol, 2,3 withdrawal emergent mania has been mostly reported with opium. 4,5 Here, we report the case of a young male with recurrent withdrawal associated manic episodes with the use of poppy husk (locally called "bhukki") who presented to a tertiary care center of central India.
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