title: Substance use and its implications for the critical care nurses: a literature review.
abstract: BACKGROUND
  Illicit drug use in Australia has been increasing and studies indicate that illicit drug users have a higher risk of accidents which may result in the user needing critical care. However, there is a significant gap in the literature specifically pertaining to the implications of drug use in critical care.
  
  
  OBJECTIVE
  The primary objective was to examine the literature for the physiological effects of methylenedioxymethamphetamine (MDMA), cocaine and amphetamines in critically ill patients.
  
  
  METHODS
  A comprehensive literature review was undertaken and a body systems framework was used to categorise the effects of these illicit drugs.
  
  
  RESULTS
  The illicit substances addressed have potentially fatal and long-term side effects. For those users involved in accidents or trauma requiring intensive or critical care nursing, the mortality and co-morbidity risks are increased significantly. It is, therefore, important that nurses are able to recognise the specific physiological effects and possible complications that can occur with the use of each illicit drug.
  
  
  CONCLUSIONS
  Both nursing and medical staff need to have a thorough understanding of how illicit substances work and how they can affect the critical care patient and the care they are given.
authors.affiliation: La Trobe University/Alfred Clinical School of Nursing, Alfred Hospital, Prahran, Melbourne 3004, Australia. vanessa.brotto@deakin.edu.au <vanessa.brotto@deakin.edu.au>
authors.forename: Vanessa
authors.initials: V
authors.lastname: Brotto
authors.forename: Geraldine
authors.initials: G
authors.lastname: Lee
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology; D000662:Amphetamines / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology; D003042:Cocaine / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology; D003422:Critical Care / Q000379:methods*; D006801:Humans; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology; D020521:Stroke / Q000139:chemically induced; D019966:Substance-Related Disorders / Q000451:nursing*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000662:Amphetamines; D003042:Cocaine; D018817:N-Methyl-3,4-methylenedioxyamphetamine