Scherbaum Norbert, Bonnet Udo
LVR-Universitätsklinik Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Duisburg-Essen, Virchowstraße 174, 45147, Essen, Deutschland.
Klinik für Seelische Gesundheit, Ev. Krankenhaus Castrop-Rauxel, Castrop-Rauxel, Deutschland.
Nervenarzt. 2025 Jun 18. doi: 10.1007/s00115-025-01831-9.
The use of psychoactive substances is associated with the risk of somatic complications requiring treatment. Psychiatric consultations can be requested in this context.
Description of physical and psychological complications of acute and chronic use of various drugs (except alcohol and benzodiazepines), and the procedure for consultations.
Narrative literature review.
Severe physical and psychological complications of drug use can also occur with sporadic use. New psychoactive substances (NPS) in particular are known to have severe side effects compared to plant-based drugs with similar effects. Sporadic drug use, harmful use, and dependence must be differentiated diagnostically. Somatic complications of chronic use usually occur with dependent use, especially with intravenous drug administration. Depending on the individual case, recommendations for abstinence, safer use, or motivational interventions to take up a subsequent support program should be made. This requires precise knowledge of the local treatment network for drug users. Medication is used to alleviate withdrawal symptoms symptomatically. Potential complications must be taken into account during withdrawal treatment, e.g. withdrawal delirium and seizures in the case of GABA-ergic drugs. Maintenance treatment is the therapy of choice for opioid addicts.
Addiction psychiatry consultations should not only offer help in the management of current clinical problems, but should also show those affected the possibilities of further care and treatment.
使用精神活性物质与需要治疗的躯体并发症风险相关。在此背景下可寻求精神科会诊。
描述各种药物(酒精和苯二氮䓬类药物除外)急性和慢性使用的生理及心理并发症,以及会诊流程。
叙述性文献综述。
药物使用的严重生理和心理并发症也可能发生在偶尔使用的情况下。尤其是新型精神活性物质(NPS),与具有类似效果的植物性药物相比,已知具有严重的副作用。必须在诊断上区分偶尔使用、有害使用和药物依赖。慢性使用的躯体并发症通常发生在药物依赖的情况下,尤其是静脉注射用药时。应根据具体情况,就禁欲、更安全使用或采取后续支持计划的动机干预提出建议。这需要对当地吸毒者治疗网络有精确的了解。药物用于对症缓解戒断症状。在戒断治疗期间必须考虑潜在并发症,例如γ-氨基丁酸能药物所致的戒断谵妄和癫痫发作。维持治疗是阿片类成瘾者的首选治疗方法。
成瘾精神科会诊不仅应在处理当前临床问题方面提供帮助,还应向受影响者展示进一步护理和治疗的可能性。