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Psychiatric consultants in hospital settings often encounter patients with substance use disorders (SUDs). Patients who are intoxicated are more likely to be injured in traumatic accidents, and there is a significant association between having a SUD and injury from physical trauma. Risk-taking behavior associated with drug use can lead to sexually transmitted diseases and other infections, including those acquired through injection drug use (e.g., cellulitis, endocarditis, HIV, hepatitis C virus [HCV]). SUDs are more prevalent in patients who have depression or anxiety disorders or other psychiatric comorbidities (including personality disorders) and in those who use tobacco or alcohol. Patients with a dual diagnosis (i.e., both SUD and another major psychiatric disorder) may present with complex clinical histories and symptoms that make diagnosis challenging. Intoxication and withdrawal symptoms may be mistaken for other psychiatric or medical symptoms. Hospitalization may be prolonged by delirium due to intoxication or withdrawal.
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