Characteristics of Psychiatric Emergency Room Patients With Alcohol- or Drug-Induced Disorders

Szuster, Richard R.; Schanbacher, Bridget L.; McCann, Sean

doi:10.1176/ps.41.12.1342

Cited by 19 publications

(17 citation statements)

References 9 publications

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“…This may in part relate to medical conditions associated with SUD evaluated in these settings (e.g., injuries evaluated in the emergency room). This finding is consistent with a report from psychiatric emergency room visits, which found that individuals with a substance-induced disorder were more likely to be males (Szuster et al, 1990). Gender differences in the type and quantity of substances used, in the severity of the SUD, or in attitudes toward treatment utilization may also partly explain these differences.…”

Section: Discussionsupporting

confidence: 92%

Gender Differences in Substance Abuse Treatment and Barriers to Care Among Persons With Substance Use Disorders With and Without Comorbid Major Depression

Chen

Strain

Crum

et al. 2013

Journal of Addiction Medicine

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Objectives To compare substance use disorders (SUD) treatment patterns and barriers to such treatment among men and women with SUD with and without comorbid major depressive episodes (MDE) in a community sample. Methods Using data from adult participants in the National Survey on Drug Use and Health 2005-2010, we investigated differences by gender in the association of MDE comorbidity with SUD on patterns of, perceived unmet need for, and the perceived barriers to SUD treatments. Results Compared to participants with SUD without MDE, both men and women with comorbid SUD and MDE were more likely to use SUD services or to report an unmet need for such treatment. Gender modified the association of comorbidity and treatment patterns: males with MDE comorbidity had a greater likelihood of emergency room visits and use of inpatient services than females. Barriers to substance treatment were remarkably similar for males and females in both the SUD without MDE, and with MDE groups, with attitudinal factors being the most common barriers. Conclusions Comorbidity with MDE appears to be an important predictor of service utilization and perceived need for SUD treatment in both men and women. The association of comorbidity with the use of some types of services, however, appears to vary according to gender. The findings have implications for the design of gender-specific SUD treatment programs.

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Section: Discussionsupporting

confidence: 92%

Gender Differences in Substance Abuse Treatment and Barriers to Care Among Persons With Substance Use Disorders With and Without Comorbid Major Depression

Chen

Strain

Crum

et al. 2013

Journal of Addiction Medicine

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“…10,12 Once organic causes have been ruled out, the primary source of agitation can be presumed to be psychiatric, which may include, but is not limited to, behavioral disorders, severe anxiety, homicidal thinking, or psychosis. Agitation stemming from organic causes may include adverse neurological events (eg, seizures, trauma, or cerebrovascular accidents), infection, or metabolic changes and should be differentiated through a thorough physical examination and toxicology screens of blood and urine, if possible.…”

Section: Assessing Agitationmentioning

confidence: 99%

Pharmacological Management of the Agitated Pediatric Patient

&NA;

2010

Pediatric Emergency Care

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Children with behavioral or psychiatric complaints are often evaluated in pediatric emergency room settings, and may present as agitated or violent at any point during the evaluation process. Emergency departmentYbased practitioners should be aware of risk factors associated with agitation and should be able to assess the agitated patient in a timely fashion. Management may require the use of pharmacological agents that can mitigate agitation safely and effectively, thus ensuring good outcomes for patients and emergency department staff. TARGET AUDIENCEThis CME activity is intended for pediatricians, emergency medicine physicians, nurse practitioners, and physician assistants providing acute care in pediatric emergency care settings. The focus is on the pharmacological management of agitated pediatric patients. The goals, risks, benefits, and empirical support of these practices are reviewed. LEARNING OBJECTIVESAfter completion of this article, the reader should be better able to:1. Evaluate predictive indicators of risk for agitation and/or violence in the pediatric population. 2. Assess the risks and benefits of common pharmacological management practices for agitated pediatric patients, and the rationale for choosing specific management agents. 3. Demonstrate the goals of pharmacological interventions in the agitated patient as related to timing of intervention, choice of pharmacological agent, dosing parameters, and the pre-vention, assessment, and management of adverse effects associated with these interventions in the emergency setting. CME REVIEW ARTICLE 856 www.pec-online.com

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“…The 1991 NIDA Household Survey, which generally underestimates drug usage, indicated that I5 percent of high school seniors had illicitly used stimulants at least once in their lifetime [54]. More recently, Japan, the West Coast, and Hawaii have seen an increase in amphetamine abuse, where "ice" and "glass" rival or surpass use of cocaine [55].…”

Section: Abuse Potentialmentioning

confidence: 99%

Toxicity and Abuse of Prescribed Stimulants

Spier

1995

Int J Psychiatry Med

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Concerns about the toxicities of psychomotor stimulants originate primarily from effects seen at high doses, when stimulants are abused. Low dose use in the apathetic medically ill patient has been generally associated with only minimal, short lived side effects, which are detailed herein. Confusion may be worsened in already delirious patients. Anxiety, psychosis, cardiovascular effects, insomnia, and tremor may occur but infrequently require discontinuation. Appetite is normally stimulated in the medically ill. In fact, stimulants are frequently utilized in the medically ill largely because of their minimal toxicity. The history of U.S. stimulant abuse in the twentieth century is briefly discussed. Abuse of prescribed stimulants appears to be infrequent. Over-zealous concern regarding abuse has previously led to unfortunate declines in appropriate utilization of stimulants, e.g., for attention deficit disorder. Guidelines for prescribing stimulants in light of abuse potential are included.

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Characteristics of Psychiatric Emergency Room Patients With Alcohol- or Drug-Induced Disorders

Cited by 19 publications

References 9 publications

Gender Differences in Substance Abuse Treatment and Barriers to Care Among Persons With Substance Use Disorders With and Without Comorbid Major Depression

Gender Differences in Substance Abuse Treatment and Barriers to Care Among Persons With Substance Use Disorders With and Without Comorbid Major Depression

Pharmacological Management of the Agitated Pediatric Patient

Toxicity and Abuse of Prescribed Stimulants

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