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PPT : Substance Abuse and Addictions

People with addictions are more likely to be treated poorly than those with any other disorder.

The Challenges
* Diagnostic: Evolving nomenclature & predominately behavioural criteria.
* Limited medical education, with an emphasis on helplessness and hopelessness.
* Difficult patients with difficult patterns of behaviour.
* Shallow repertoire of medical responses.
* Poor coordination of services.
* Chronic, relapsing, often chaotic disease course.
* Social & professional stigma.
* 40 y.o. male, chronic alcoholic “frequent flyer” presents again to ED with alcohol related trauma. Known for his hair spray ingestion and repeated trauma.
* GCS 8 (E2 V3 M3), BP 120/70, P 90, SaO2 92% Disheveled. Smells of booze. Speech incomprehensible.
* H&N: Several hematoma. Left parietal laceration. Right eye ecchymosis with lid swollen shut.
* CVS: WNL
* RESP: Right basal inspiratory crackles.
* ABD: Soft, non-tender. Palpable liver edge. BS normal.
* EXT: Proximal left calf stab wound. Multiple bruises.
* NEURO: Semi-comatose. No lateralizing signs.

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Tags: medical education, medical responses

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