Substance Use Disorders

F10.0-F19.9 + (R45.0-8/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8)

• Description
• General measures
• Medicine treatment
• Referral

Consult National Policy guidelines on detoxification of psychoactive substances.

DESCRIPTION

Substance use disorder is mental and physical symptoms caused by the use of one or more substance despite significant substance-related problems (including abuse and dependence). Substance-induced disorders include intoxication, withdrawal and other substance/medication-induced mental disorder.

Alcohol withdrawal

See Alcohol withdrawal (uncomplicated) .

Methamphetamines (tik), cocaine (crack), methaqualone (mandrax), cannabis

These patients usually do not require hospitalisation.

GENERAL MEASURES

Reassurance and support of the patient and family.

MEDICINE TREATMENT

For severe anxiety, irritability and insomnia:

• Benzodiazepine, e.g.:
  • Diazepam, oral, 5–10 mg as a single dose or 12 hourly for 5–7 days.

For seizure control and /or sedation:

• Diazepam, slow IV, 10 mg

LoEIII [20]

REFERRAL

• Severe alcohol dependence.
• Past history of withdrawal seizures or a history of epilepsy.
• Past history of Delirium Tremens.
• Younger (< 12 years of age) or older age (> 60 years of age).
• Pregnancy.
• Significant polydrug use.
• Cognitive impairment.
• Lack of support at home or homelessness.
• Previous failed community detoxification attempts.
• Opioid substance use disorder.