SCCM Resource Library-Critical Care Management of Adults With Substance Abuse Disorders: The Forest Through the Trees

Pdf Summary

The Spring 2023 issue of Critical Connections focuses on the challenges of managing Substance Use Disorders (SUDs) in intensive care units (ICUs). SUDs, encompassing conditions such as Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD), represent a significant mental health concern with rates nearly doubling from 2013 to 2020. This increase has directly impacted ICU admissions, as critically ill patients with SUDs often present with complex health challenges, including multisystem organ failure and prolonged ICU stays.<br /><br />For AUD, about 10-20% of ICU admissions are related to alcohol issues, with many patients experiencing Alcohol Withdrawal Syndrome (AWS). Management involves supportive care and medications like benzodiazepines (BZDs) and barbiturates, though these come with risks like excessive sedation. Adjunctive therapies such as dexmedetomidine and ketamine are also used to manage symptoms and minimize BZD use.<br /><br />Opioid-related ICU admissions have risen due to increased opioid usage, necessitating efficient recognition and treatment of opioid overdose and withdrawal. Critical care strategies include the use of naloxone for overdose and combination therapies for withdrawal management.<br /><br />Stimulant abuse presents additional challenges in critical care, with symptoms ranging from agitation to severe cardiovascular events. Treatment primarily involves supportive care, often with BZDs to manage sympathetic overactivity.<br /><br />Managing these SUD-related complications in the ICU requires a multidisciplinary approach, incorporating anesthesiologists, pharmacists, and addiction specialists. Continued research and guidelines are crucial for improving post-ICU care for patients with SUDs.

Asset Subtitle

Behavioral Health and Well Being, 2023, 0:06:27

Asset Caption

"This article was first published in the Spring 2023 issue of Critical Connections.

Substance use-abuse disorders (SUDs) isare a major public health concern, with rapid increases in prevalence reported over the years. The 2020 National Survey on Drug Use and Health reported that, among individuals aged 12 and older, SUD rates nearly doubled, from 21.6 million in 2013 to 40.3 million (14.5% of the population) in 2020. In a recent study examining the burden of substance abuse-related ICU admissions in a large county hospital, about 25% of admissions related to substance abuse accounted for 23% of total charges.

Critical Connections, the critical care industry’s only newsmagazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team."

Meta Tag

Content Type Article

Knowledge Area Behavioral Health and Well Being

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Alcohol and Substance Abuse

Year 2023

Keywords

Substance Use Disorders

Intensive Care Units

Alcohol Use Disorder

Opioid Use Disorder

Alcohol Withdrawal Syndrome

Benzodiazepines

Opioid Overdose

Stimulant Abuse

Multidisciplinary Approach

Critical Care

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