Subject(s)
Opioid-Related Disorders/therapy , Buprenorphine/therapeutic use , Drug Combinations , Drug Overdose/prevention & control , Humans , Methadone/therapeutic use , Motivation , Naloxone/therapeutic use , Narcotic Antagonists/therapeutic use , Narcotics/administration & dosage , Narcotics/therapeutic use , Opioid-Related Disorders/psychology , Opioid-Related Disorders/rehabilitation , Recurrence , South Africa , Substance Withdrawal Syndrome/prevention & controlABSTRACT
OBJECTIVE: Little is known about the epidemiology of substance use disorders (SUD) among psychiatric inpatients in the Western Cape, South Africa. Therefore, this study was conducted to examine the prevalence of SUD among acute adult psychiatric inpatients at Stikland Hospital, one of three state acute psychiatric hospitals in the Western Cape. METHOD: A prospective descriptive prevalence survey was undertaken over a three-month period. During this period, data was collected on psychiatric patients (N=298) who were hospitalized in the acute psychiatric wards at Stikland. This included patient demography, psychiatric and substance use history. Urine was also collected and analyzed for substances commonly abused in the Western Cape. RESULTS: A co-morbid SUD (abuse or dependence) was diagnosed in 51% of patients. In addition, a diagnosis of a substance-induced psychiatric disorder was made in 8% of these patients, 1% of who was diagnosed with a substance-induced mood disorder, while 7% was diagnosed with a substance induced psychotic disorder. Patients diagnosed with a co-morbid SUD were younger than those without a SUD and more likely to have been involuntary admissions. These patients also displayed more violence prior to admission that contributed to their admission and were more likely to have used cannabis or methamphetamine as their preferred drug of abuse. Only a small group of patients had documented evidence of any prior interventions for their SUD. CONCLUSION: SUD are prevalent among psychiatric inpatients and contribute to their morbidity. This has implications for staff training and service development.
Subject(s)
Illicit Drugs , Mental Disorders/epidemiology , Patient Admission/statistics & numerical data , Substance-Related Disorders/epidemiology , Adolescent , Adult , Aged , Amphetamine-Related Disorders/diagnosis , Amphetamine-Related Disorders/epidemiology , Amphetamine-Related Disorders/rehabilitation , Commitment of Mentally Ill/statistics & numerical data , Comorbidity , Cross-Sectional Studies , Diagnosis, Dual (Psychiatry) , Female , Hospitals, Psychiatric/statistics & numerical data , Hospitals, State/statistics & numerical data , Humans , Male , Marijuana Abuse/diagnosis , Marijuana Abuse/epidemiology , Marijuana Abuse/rehabilitation , Mental Disorders/diagnosis , Mental Disorders/rehabilitation , Methamphetamine , Middle Aged , Psychoses, Substance-Induced/diagnosis , Psychoses, Substance-Induced/epidemiology , Psychoses, Substance-Induced/rehabilitation , South Africa , Substance Abuse Detection/statistics & numerical data , Substance-Related Disorders/diagnosis , Substance-Related Disorders/rehabilitation , Violence/psychology , Violence/statistics & numerical data , Young AdultABSTRACT
Objective : With the increase in opioid dependence in South Africa; medical practitioners are increasingly confronted with requests to treat patients with opioid use disorders. Many medical practitioners; however; do not possess the required knowledge and skills to effectively deal with these patients. An overview of the medical treatment of opioid dependence is provided. Method : A working group of key doctors working in the field of substance dependence; was elected at an Opioid Experts Meeting and compiled guidelines for the management of opioid dependence. This article provides a summery of these guidelines. Recommendations are based on current best practice as derived from scientific evidence and consensus of the working group. It should never replace individual clinical judgment
Subject(s)
Analgesics , Analgesics, Opioid , Mental Health , Pharmaceutical Preparations , Practice Management , Substance-Related DisordersABSTRACT
During the Lebanon War, 1982, over 80% of the wounded were sent from the triage area of the hospital directly to the radiology department. This article reports changes in the working pattern and organization of the department that were instituted for emergency treatment in wartime, and describes radiological examination methods for different organs. Computerized tomography is emerging as the most important diagnostic tool in addition to conventional radiological examinations.
Subject(s)
Hospital Departments , Military Medicine , Radiology Department, Hospital , Warfare , Wounds and Injuries/diagnostic imaging , Abdominal Injuries/diagnostic imaging , Humans , Lebanon , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
Diagnostic radiology in wartime: During the Lebanon war, 1982, over 80 percent of the wounded were sent from the triage area of the hospital directly to the radiology department. This article reports chances in the working pattern and organization of the department that were instituted for emergency treatment in wartime and describes radiological examinations methods for different organs. Computarized tomography is emerging as the most important diagnostic tool in addition to conventional radiological examinations (AU)
