Substance-abuse disorders tolerance

Benzodiazepines are safe and remarkably well tolerated. The most common side effect is drowsiness. However, elderly patients may experience confusion and a lack of coordination that increases the risk of falls. The benzodiazepines are not without abuse liability and should be used sparingly in patients with a history of a substance use disorder. 

In DSM-IV parlance, psychiatric illnesses that result from substance use are called substance-related disorders. Within this broad spectrum are two distinct categories substance use disorders and snbstance-induced disorders. The substance use disorders consist of abusive patterns of nse that produce a myriad of problems in relationships, employment, medical or physical well-being, and legal matters. There is no predefined amount or frequency of substance use that defines these disorders instead, they are diagnosed when the consequences of substance use include an adverse impact on other areas of life. As noted earlier, in some instances, substance nse disorders lead to physical dependence that is manifested by tolerance and the potential for withdrawal symptoms. When anyone talks about addiction, it is typically snbstance nse disorders to which they refer. 

SAD can present in children of preschool to elementary school age. If the disorder is not treated, it can persist into adulthood and increase the risk of depression and substance abuse. CBT and social skills training are effective nonpharmacological therapies in children. Pharmacological evidence is limited to case studies or open-label trials. SSRIs are considered first-line therapy because of tolerability and effectiveness. Fluoxetine, fluvoxamine, sertraline, and paroxetine were effective in children with SAD. Headache, nausea, drowsiness, insomnia, jitteriness, and stomach aches were reported in children receiving SSRIs. 

Sateia and Nowell [85] have proposed that long-term treatment with hypnotic medication could be implemented in patients with persistent insomnia not related to mental disorders, neurological diseases, medical conditions, or the effect of a substance of abuse or medication. In addition, nonpharmacological approaches have to be proven ineffective. Circumstances in which the long-term administration of hypnotic drugs must be discontinued include the development of tolerance and dose escalation, the occurrence of severe adverse events, and the diagnosis of newly developed disabilities. 

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