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      Manejo do paciente com transtornos relacionados ao uso de substância psicoativa na emergência psiquiátrica Translated title: Management of patients with substance use illnesses in psychiatric emergency department

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          Abstract

          OBJETIVO: Transtornos por uso de substâncias são prevalentes em setores de emergência gerais e psiquiátricos, atingindo taxas de 28% das ocorrências em prontos-socorros gerais. Todavia, profissionais dos setores de emergência identificam menos que 50% dos casos de problemas relacionados ao álcool. Este artigo visa fornecer base fundamentada em evidências para o tratamento específico a pacientes que preencham os critérios diagnósticos de transtornos por uso de substâncias e que se apresentam ao pronto-socorro em quadros de intoxicação ou abstinência. MÉTODO: Uma revisão sobre o tema foi realizada na base de dados Medline, usando-se os descritores "intoxicação aguda", "abstinência", "álcool", "cocaína", "cannabis", "opioides", "inalantes" e "manejo", tendo o inglês como idioma. RESULTADOS E CONCLUSÃO: O cuidado de pessoas com transtornos por uso de substâncias deve conter: avaliação completa (médica geral e psiquiátrica), tratamento dos quadros diagnosticados (abstinência, intoxicação e quadros clínicos que caracterizem uma emergência), sensibilização do paciente para realizar tratamento, se for necessário, e elaboração de encaminhamento.

          Translated abstract

          OBJECTIVE: Substance use disorders are prevalent in emergency departments in medical and psychiatric services, reaching rates of 28% of cases in medical emergency departments. However, professionals in the emergency department identify less than 50% of cases of alcohol-related problems. This article aims to provide evidence-based interventions for the specific treatment to patients who meet diagnostic criteria for substance use disorders and who present to emergency rooms during intoxication or abstinence. METHOD: A literature review was performed on Medline database, using the descriptors "acute intoxication", "withdrawal", "alcohol", "cocaine", "cannabis", "opioid", "inhalant", "management", using English as the language. RESULTS: AND CONCLUSION: The care of persons with substance use disorders should include: comprehensive assessment (medical and psychiatric), treatment of diagnosed disorders (withdrawal, intoxication and clinical features that characterize an emergency), awareness of the patient to carry out treatment if necessary and referral.

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          Most cited references49

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          Results from the 2008 National Survey on drug use and health: National Findings

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            Alcohol and injuries: a review of international emergency room studies.

            This paper reviews emergency room (ER) studies from a number of countries which have focused on the association of alcohol and casualties. The review emphasizes studies which used probability sample of patients to represent the population of the emergency facility where the data were collected, and which separated injured patients from patients with medical conditions not due to injuries (the 'non-injured'). Reviewed here are studies concerned with: (1) estimated prevalence of positive blood alcohol at the time of the ER visit; (2) self-reported alcohol consumption prior to the event resulting in a need for ER treatment; (3) patients' descriptions of their usual drinking patterns and alcohol-related problems; (4) predictions of casualties and of alcohol-related casualties. Comparisons of findings from several countries are also presented. Comments on limitations of ER studies as well as other issues pertaining to the usefulness and interpretation of such data, and future directions for research in emergency room populations are discussed.
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              Ethanol and cocaine interactions in humans: Cardiovascular consequences

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbp
                Revista Brasileira de Psiquiatria
                Rev. Bras. Psiquiatr.
                Associação Brasileira de Psiquiatria - ABP (São Paulo )
                1809-452X
                October 2010
                : 32
                : suppl 2
                : S104-S111
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Faculdade de Medicina do ABC Brazil
                Article
                S1516-44462010000600007
                10.1590/S1516-44462010000600007
                6daa33fa-69d9-4ae3-880e-6e1b8adc4a6d

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1516-4446&lng=en
                Categories
                PSYCHIATRY

                Clinical Psychology & Psychiatry
                Substance-related disorders,Patients,Emergency services, psychiatric,Intoxication,Withdrawal,Management,Transtornos relacionados ao uso de substâncias,Serviços de emergência psiquiátrica,Intoxicação,Abstinência,Manejo

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