Intravenous drug abuse and one academic health center

Article Abstract:

Hospital personnel are well-aware that patients who are intravenous drug abusers are frequently difficult to manage because of disruptive behavior, which can include abuse of staff members and drug trafficking in the hospital. These problems led to a study at The Johns Hopkins Hospital designed to investigate the frequency and management of patients who are intravenous drug abusers. Hospital records were examined for the years 1983 to 1988, and it was found that the diagnosis of drug addiction (excluding alcohol and nicotine abuse) increased from 0.6 percent to 3.5 percent of all hospital patients in this time period. The medical records showed documentation of disruptive behavior in 38 of 71 current cocaine or heroin users compared with 12 of 64 matched control patients during 1988. In the area of patient education, the medical staff focused primarily on teaching these patients about the complications of intravenous drug abuse. The researchers recommended that a drug abuse treatment, education and research program be established, including an inpatient unit. An explicit social contract should also be drawn up between the staff and the patient. Hospital staffs need more information on the legal aspects of searching patients for drugs and managing disruptive outbursts. A long-term goal to prevent substance abuse was identified; one prevention method is to fight society's tendency to enable and condone substance abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Drug abuse treatment, Drug addicts, Drug abusers, Drug abuse

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Are we comfortable with homelessness?

Article Abstract:

The 91 percent rate of mental illness in homeless women and the 85 percent rate of substance abuse, primarily among homeless men, attest to the major problems facing the homeless population in the U.S. Medical problems compound the effect of homelessness; for example, while poor health may itself be a cause of homelessness, homeless people may not be able to receive adequate or timely care for simple disorders. A problem such as frostbite, when left untreated, may escalate into complications leading to amputation. AIDS among the homeless has shed light on the health care needs of this population. AIDS is now an overwhelming problem, and some experts believe that it may develop into one of the primary health care problems among the homeless. At present, substance abuse among the homeless is the primary health care problem, and this complicates the treatment of other medical conditions. Mental illness, which afflicts a large portion of the homeless population, may result in behavior which masks underlying health problems. The manner in which a society treats its poor, in this case the homeless, is often an indication of the strength of that society as a whole. There is a need for physicians to advocate the use of public money to: enhance public housing; enhance mental health care, and establish national health care.

Alcoholism, Mental illness, Mental disorders, Homeless persons

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Tuberculosis and homelessness in the United States, 1994-2003

Article Abstract:

A study is conducted to describe homeless persons with tuberculosis (TB) and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Individual TB risk factors often overlap with risk factors for homelessness and the social contexts in which TB occurs are often complex and important to consider in planning TB treatment.

United States, Public affairs, Risk factors, Tuberculosis, Tuberculosis patients

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