Drug use in the chemically dependent

Abstract

Unsupervised use of intoxicating drugs almost certainly causes relapse to addiction in persons who have been chemically dependent. Other drugs may predispose some persons to failure in their attempt to remain drug-free. Studies have shown that the chemically dependent are addicted to intoxication, not to one particular chemical, so these persons must be guided away from psychoactive drugs that have any risk of producing intoxication. In some cases, such as during hospitalization, relapse-producing agents may be necessary. With close attention from the physician and the patient's acceptance of his or her addiction and active participation in a self-help group, relapse can usually be avoided. Benefits that are gained from counseling are often underrecognized. The physician who takes time to intervene in this way probably has fewer relapses among his or her chemically dependent patients than the physician who orders a prescription. Prescribing any drugs to these patients must be done with caution. In general, all intoxicating substances are contraindicated outside the hospital. The patient's use of any over-the-counter agent to produce weight loss, excitement, or sleep should serve as a warning signal to both the patient and physician.