ABSTRACT
The drug dependency problem in Egypt and wordwide is currently one of the major issues of concern to the public as well as the professionals. This study was conducted on all addicts with acute poisoning by drugs and or substances abuse [n= 149]. They were admitted to Alexandria Poison Center [APC] and critical care unit [CCU] at Alexandria Main University Hospital [AMUH] during six months period from January to June 2003. In this study, all addicts were clinically examined. Routine investigations, arterial blood gases and acid base status were done with detection of drug or substance of abuse in urine by Axsym and gas chromatography / mass spectrometry [GC/MS] for negative urine samples. The study showed that 71.2% of addicts were encountered in the age group 20<40 years. adolescents accounted for 15.4% of the addicts. Males outnumbered females with a sex ratio of 17.5:1. The study revealed that the majority of addicts were smokers 95.3% single 71.8% and started drug/ substance abuse in the age group 10<30 years [87.2%]. 43.7% of addicts were of low and very low social class while 28.9% were commercial workers. The duration of addiction ranged from one to 10 years. In the present study cannabis was the first abused substance [24.2%]. Hypnotics whether of benzodiazepine [14.8] or barbiturates [10.7] accounted for 25.5%. Ethyl alcohol either alone or adulterated by methyl alcohol, opiods, constituted 21.5%, 9.4% and 19.5% respectively. Female addicts were more likely to abuse benzodiazepines [75.0%]. 26.2% of addicts presented with severe poisoning and were in need of critical care interventions. The study revealed that postive urine samples for benzodiazepines, oPiates, barbiturates and cannabis accunted for 100%, 96.6% 93.8% and 72.2%, respectively. The majority of addicts recovered completely [83.2%], deaths accounted for 3.4% of the total addicts. It is recommended that, Continuous health education and prevention programs concerning health hazards of drug and substance abuse among adolescents and young adults are highly indicated. In addition the Staff of poison centters and emergency departments, should be well trained to deal with diagnosis and management of overdose in addicts. Also screening immunoassay technique should be done on all urine samples of addicts and better to be confirmed using GC/MS, as the latter is more reliable in legal cases, where it can stand court defense