Management of hospitalized intravenous drug users: role of the internist.
Intravenous drug users present significant clinical challenges to internists. In this paper, we review common clinical dilemmas faced by internists when managing intravenous drug users in the inpatient hospital setting. Articles were identified through a MEDLINE search and bibliographies of published articles. Studies and reviews were selected for information relevant to the management of hospitalized intravenous drug users. Seventy-three papers were selected for this review. We summarize data and information from the relevant literature concerning common presenting medical problems (fever, musculoskeletal pain, and dyspnea), the importance of knowing patients' HIV status, common behavioral issues, special concerns of women, and the diagnosis and management of drug withdrawal in intravenous drug users. We also offer recommendations for hospital discharge planning. With appropriate knowledge of the epidemiology and management of important medical and substance use problems among intravenous drug users, internists may more effectively care for them in the hospital setting.
Department of Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8025.
P G
PG
O'Connor
J H
JH
Samet
M D
MD
Stein
D004417:Dyspnea / Q000628:therapy; D005260:Female; D005334:Fever / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007388:Internal Medicine; D009140:Musculoskeletal Diseases / Q000628:therapy; D059408:Pain Management; D010351:Patient Discharge; D010819:Physician's Role; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000628:therapy*