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Previous Volume 348:1786-1795 May 1, 2003 Number 18 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Each year in the United States, approximately 8.2 million persons are dependent on alcohol and 3.5 million are dependent on illicit drugs, including stimulants (1 million) and heroin (750,000).¹ In a sample from primary care practice, 15 percent of patients had either an "at-risk" pattern of alcohol use or an alcohol-related health problem, and 5 percent had a history of illicit-drug use.² With rates of substance use so high, all patients should be carefully screened with validated instruments such as the CAGE questionnaire for alcohol dependence, which consists of the following questions: Can you cut down on your drinking? Are . . . [Full Text of this Article]

Withdrawal from Sedatives (Alcohol and Benzodiazepines)

Clinical Presentation and General Management

Pharmacologic Treatment

            Benzodiazepines and Barbiturates

            Adjuvant Treatments

            Anticonvulsant Agents

Withdrawal from Opioids

Clinical Presentation

Treatment

            Opioid Medications

            Nonopioid Medications

            Rapid and "Ultra-Rapid" Detoxification

Withdrawal from Stimulants (Cocaine and Amphetamines)

Clinical Presentation

Treatment

The Role of Generalist Physicians

Clinical Features of Patients

Referral as Compared with Direct Treatment

Source Information

From the Departments of Psychiatry (T.R.K.) and Medicine (P.G.O.), Yale University School of Medicine, New Haven, Conn.; and Veterans Affairs Connecticut Healthcare System, West Haven, Conn. (T.R.K.).

Address reprint requests to Dr. Kosten at Veterans Affairs Connecticut Healthcare System, Psychiatry 151D, 950 Campbell Ave., Bldg. 35, West Haven, CT 06516, or at thomas.kosten@yale.edu.

Related Letters:

Management of Drug and Alcohol Withdrawal
Devi G., Castro V. J., Huitink J., Buitelaar D., Kosten T., O'Connor P.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:405-407, Jul 24, 2003. Correspondence

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