Substance-abuse disorders intoxication

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

The DSMIV notes the potential for caffeine to be abused and includes Caffeine Intoxication under the category of Substance Abuse Disorders.262 Despite this official classification, there continues to be controversy as to whether or not caffeine is actually a drug of abuse. Some researchers maintain that caffeine has very low, if any, potential for abuse,235 while others believe that it can be addictive and has characteristics similar to those of other addictive drugs.263... 

Substance Use Disorder. Patients abusing alcohol or other substances may be prone to erratic behavior reminiscent of the Cluster B personality disorders. If these behaviors occur exclusively in a context of intoxication or during periods of heavy substance use, then the diagnosis of a Cluster B personality disorder is not warranted. Instead, treatment should be focused on the substance use disorder. This is not to say, however, that substance use disorders and Cluster B personality disorders cannot occur together. In fact, the difficulty that these patients have in self-soothing leaves them especially vulnerable to substance abuse. 

Parkinson s disease Postslroke Malignant disease Substance use disorders (including intoxication and withdrawaO Alcoholism Marijuana abuse and dependent Nio)tine dependence Opiate abuse and dependence (eg, heroin) Psychostimulant abuse and dependence (e.g, cocaine)... 

Substance-related disorders are divided in DSM-IV into dependence, abuse, intoxication, and withdrawal. In addition, each substance may have related disorders phenomenologically similar to other disorders delirium, dementia, amnestic, psychotic, mood, anxiety, sex, and sleep disorders. 

Alcohol (ethanol) is a water-soluble substance that is rapidly absorbed and readily crosses the blood-brain barrier. It is a CNS depressant and is metabolized by the liver. It is also a gastric irritant and is toxic to liver cells and neurons. Alcohol is probably the most-studied substance of abuse (and the most abused substance). It is associated with dependence, abuse, withdrawal, intoxication, delirium, dementia, amnesia, delusions, hallucinations, mood disorder, anxiety disordei sexual dysfunction, and sleep disorder. 

Anxiety is characterized by fear and apprehension that may or may not be associated with a cieariy identifiabie stimuius. Anxiety is a common reaction to significant life stress, is seen in conjunction with almost every psychiatric disorder, and is a common component of numerous organic disorders as well (e.g., hyperthyroidism, hypoglycemia, pheochromocytoma, complex partial seizures, pulmonary disorders, acute myocardial infarction, caffeine intoxication, various substances of abuse). Anxiety is almost invariably accompanied by physical symptoms such as the following ... 

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