Syndromes Associated With Intoxication

An accurate diagnosis is of fundamental importance in the assessment of patients who may be intoxicated. A full history must be obtained in the awareness that progression to potentially fatal overdose or withdrawal syndromes may occur. The focus of physical examination should be the acute effects of intoxication (such as vital and neurologic signs) and chronic signs and symptoms associated with drug dependence (size of liver, evidence of venipuncture). Drug use within the previous 4-12 hours can be determined by analysis of blood and breath samples whereas urinalysis is useful for assessing substance use within the preceding 24-72 hours. Urinalysis is the preferred option (with the exception of determining alcohol use) though saliva testing is becoming more widely used. Immediate results can be obtained with urine testing kits suitable for use in an office or clinic.

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