Barbiturate, Sedative, Hypnotic or Anxiolytic Intoxication and Withdrawal:

This Emergencies related  to  substance abuse may be acute  or chronic. The patient may come  to  the emergency department in acute withdrawal, severe drug intoxication or seeking help for addiction. Substance abuse has been discussed  in detail in Unit 3 of Block 3. The intoxication and withdrawal of  barbiturate. Sedative hypnotic s or anxiolytics may cause alteration in mood, thought and behavior requiring emergency care. 

Management 

Collect history of  drug use. Withdrawal from barbiturates is performed in a hospital because of  risk of medical complications. 

Opioid Intoxication and Withdrawal

Patients addicted  to opioids may present requesting withdrawal or more commonly present in withdrawal requesting relief. The characteristic signs of acute intoxication include clouded consciousness, severe respiratory depression and pinpoint pupils. Death from  intoxication is due to respiratory failure. Anoxia may cause circulatory failure At  this end stage, pupils are dilated. 

Management 

In case of opium toxicity, if  patient is toxic, W administration of  narcotic antagonist (example naloxone) is  required. If  patient is withdrawing, he may be referred to a de-addiction clinic.