History, of drug use

Chen K, Kandel DB The natural history of drug use from adolescence to the midthirties in a general population sample. Am J Public Health 85 41 7, 1995... 

The above brief history of early drug use and discovery is intended to be purely illustrative and the reader is referred to an excellent treatise by Mann 1 to become well informed on the history of drug use and development from the earliest historic times to the present day. 

It is important to collect a careful history of drug use both from the patient and from close friends or family. In addition, urine drug screens should always be performed whenever a patient presents with new-onset psychosis. 

In 1985 in People v Miel, Martin Miel was charged and convicted of first-degree murder.5 The defense introduced hair test results to indicate that a key prosecution witness had lied when he said he was not using drugs at the time of the crime. Also in 1985, Robert Korner was convicted of robbery in People v Korner, however, the defense had submitted hair test results from the accused to prove that he was under the influence of drugs at the time of the crime and therefore could not have formed criminal intent. In these three cases, positive hair test results were used to demonstrate a prior history of drug use. 

By providing information on exposure to drugs over time, hair analysis may be useful in verifying self-reported histories of drug use in any situation in which a history of past rather than recent drug use is desired. Hair analysis may be especially useful when a history of drug use is difficult or impossible to obtain, such as from psychiatric patients. 

It is imperative that the diagnosis of primary (idiopathic) pulmonary fibrosis not be made until all known and potentially treatable causes of the fibrotic disease have been excluded. This can be accomplished by a systematic, thorough analysis of the patient s occupational history, family history, history of recurrent pneumonias, and history of drug use, including the use of immunosuppressive agents, antimicrobials, and miscellaneous drugs such as hydrochlorthiazide, gold salts, chlorpropamide, sulfapyridine, hydralazine, and amiodarone. 

The third protocol is to determine the level of drug use and calculate equivalent doses of phenobarbital (Table 3-5). The patient is stabilized on this dose (divided into administration every 8 hours) for a few days, and then the dose is tapered by 10% daily. Although this method has its proponents, the determination of equivalency is an approximation, drug histories are unreliable, and mixed sedative-hypnotic dependence will complicate the procedure. 

History. This includes the severity grading of the clinical reaction, the time of administration and onset of symptoms, the concomitant use of other drugs, foods or compounds (latex), previous history of drug allergy, atopy in the personal or family history, other underlying conditions such as mastocytosis or Cl esterase inhibitor deficiency. The actual preparation in its galenic identity should be stored or at least listed. 

In addition to the increased precision in the communication between the researcher and the programmer, there will be an increase in the accuracy of the data involved in the research. As Mason [23] pointed out early on in the history of computer use, authenticity and correctness are necessary for accuracy. One current controversy in the pharmaceutical industry, in fact, depends on accuracy, which in turn affects liability. People in and out of the industry are discussing how best to make research visible to potential users of drugs. 

In patients with a history of AED use, a baseline serum concentration may be useful to determine if the drug concentration is below the desired range and if a loading dose is needed. Albumin levels, renal function tests, and liver function tests can also be helpful when assessing antiepileptic therapy. 

Treat conditions that cause bothersome maternal symptoms during pregnancy with drug therapy only after non-pharmacologic methods fail. Choose therapy with the longest history of safe use in pregnancy. 

High-potency benzodiazepines (e.g., clonazepam and lorazepam) are common alternatives to or in combination with antipsychotics for acute mania, agitation, anxiety, panic, and insomnia or in those who cannot take mood stabilizers. Lorazepam IM may be used for acute agitation. A relative contraindication for long-term benzodiazepines is a history of drug or alcohol abuse or dependency. 

There are, however, subgroups of young adults who may not mature out of drug problems as easily as others. Those who seem to have problems maturing out usually have other problems that preceded the onset of drug use. For instance, researchers have found that young adults who have a history of Conduct Disorder or who have other psychiatric disorders (such as schizophrenia, Bipolar Disorder, depression, Anxiety Disorder, or a major personality disorder) mature out of drug problems at much lower rates than those who do not have these additional problems. 

Any history of drug or alcohol abuse by a patient should trigger a request for appropriate blood and urine tests. Blood samples should always be taken to assess the levels of study drugs and any concomitant agents used. The drug containers should always be analyzed to confirm their contents. This usually entails sending these drugs to their manufacturer. 

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