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Source: Doering PL, Li RM. Substance-related disorders I: overview and depressants, stimulants, and hallucinogens. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146064131. Accessed April 18, 2017.
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Substance-related disorders include disorders of:
Intoxication.
Dependence.
Withdrawal.
Intoxication is maladaptive behavior during waking state after recent ingestion and presence in body of substance that causes central nervous system (CNS) effects.
Substance dependence is continued pattern of substance use in spite of repeated adverse consequences related to repeated use.
Physical dependence is state of adaptation manifested by withdrawal syndrome after:
Withdrawal is development of substance-specific syndrome after cessation or reduced intake of substance that had been used regularly.
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Emergency department (ED) visits involving benzodiazepines outnumber those of other psychotherapeutic agents.
In 2010, approximately 408,021 ED visits involved nonmedical use of benzodiazepines.
Alprazolam and clonazepam implicated more frequently than diazepam and lorazepam.
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CLINICAL PRESENTATION
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When toxicology screens necessary, blood or urine should be collected immediately when patient presents for treatment.
Qualitative testing useful to confirm presence of benzodiazepines for diagnostic purposes.
Quantitative plasma concentrations not usually helpful.
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DIFFERENTIAL DIAGNOSIS
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