Dr. Saurabh Kumar
MBBS, M.D. (Psychiatry) 15 years experience overall Psychiatrist , Neuropsychiatrist , Sexologist
Substance Use Related Emergencies in a Tertiary Care General Hospital Setting: Observations and Discussion
Published In: Indian Journal of Psychological Medicine
About Indian Journal of Psychological Medicine: The Indian Journal of Psychological Medicine is a respected, peer-reviewed publication that provides a platform for scholarly discourse on psychological and psychiatric medicine. Published by Medknow, the journal encourages contributions that enrich the understanding of mental health, especially in contexts pertinent to India and other developing nations. It serves as a vital resource for mental health professionals, offering cutting-edge research, case studies, and expert perspectives on various psychiatric issues
Abstract
Authored by Dr. Saurabh Kumar and Dr. Raman Deep, this insightful article titled "Substance Use Related Emergencies in a Tertiary Care General Hospital Setting: Observations and Discussion," published in the Indian Journal of Psychological Medicine, explores the critical issue of substance use-related emergencies in an Indian healthcare context. Through a retrospective analysis of psychiatric emergency referrals at a tertiary care hospital, the article sheds light on the prevalence, demographic patterns, and the medical and psychiatric challenges associated with substance use crises in emergency settings.
Key Findings of the Research:
Prevalence of Substance Use Emergencies: The study reveals that substance use-related emergencies accounted for 12.6% of all psychiatric emergencies during the 13-month review period. This figure aligns with findings from other Indian studies but remains lower than those reported in Western contexts, where the rates are significantly higher. The study suggests that this discrepancy may be due to underreporting, underutilization of healthcare services, and cultural differences in seeking treatment.
Demographic Patterns: A key demographic insight from the study is that males overwhelmingly constitute the majority (91.7%) of substance use-related emergency cases, with the average age of individuals being around 36 years. This pattern underscores the need for gender-sensitive approaches in addressing substance use and its associated emergencies.
Primary Substances of Concern: The study identifies alcohol as the most common substance precipitating emergencies, accounting for 73.8% of cases. The predominance of alcohol-related emergencies, including severe withdrawal symptoms such as seizures and delirium tremens, emphasizes the urgent need for comprehensive alcohol management programs in hospital settings. Other substances, such as opioids and cannabis, accounted for a smaller proportion of cases but still represent significant public health concerns.
Clinical Implications: One of the study's notable findings is the underrepresentation of opioid users in emergency settings, a trend that contrasts with Western data. This disparity may be attributed to a range of factors, including fear of legal repercussions, lack of resources, and reliance on alternative community health services. The authors call for improved secondary prevention strategies, particularly community-based interventions, to mitigate the risk of opioid overdoses and other substance use crises.
Changes Over Time: Comparing the findings with data from previous decades, the authors note an evolving trend in substance use referrals, with a shift from predominantly police-driven referrals to more clinically oriented referrals. This shift suggests a growing acceptance of the medical model for substance use treatment in India, marking progress in the field of addiction psychiatry.
Applicability to the General Population:
The findings of this research carry profound implications for both public health policy and clinical practice. The prevalence of substance use-related emergencies, particularly those related to alcohol, highlights the urgent need for stronger, more accessible addiction services in general hospitals. For the broader population, the study emphasizes the importance of early intervention and ongoing support for individuals struggling with substance use disorders, with a particular focus on managing withdrawal symptoms and preventing relapses.
Furthermore, the research calls attention to the gendered nature of substance use treatment-seeking behavior, suggesting that targeted outreach and interventions for underrepresented groups, such as women, are essential for more comprehensive care. The study also advocates for the implementation of screening tools and the presence of dedicated psychiatry personnel in emergency departments to improve the detection and management of substance-related issues.
In conclusion, this article offers valuable insights into the nature and management of substance use-related emergencies in India, urging the medical community to enhance both prevention and treatment strategies. It underscores the need for a more integrated approach to addressing substance use disorders, combining clinical interventions with community-based support to ensure better outcomes for individuals facing these crises.
Author Information: Modak, Tamonud, Swarndeep Singh, Saurabh Kumar, and Raman Deep. "Substance Use Related Emergencies in a Tertiary Care General Hospital Setting: Observations and Discussion." Indian Journal of Psychological Medicine 41, no. 6 (2019): 595-597.
View Original Research