Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Mar 1;140(3):604-615.
doi: 10.1213/ANE.0000000000007078. Epub 2024 Aug 8.

Substance-Use Disorders in Critically Ill Patients: A Narrative Review

Rebecca Piland  1 , Russell Jack Jenkins  2 , Dana Darwish  1 , Bridgette Kram  3 , Kunal Karamchandani  1
Affiliations
Review

Substance-Use Disorders in Critically Ill Patients: A Narrative Review

Rebecca Piland et al. Anesth Analg. .

Abstract

Substance-use disorders (SUDs) represent a major public health concern. The increased prevalence of SUDs within the general population has led to more patients with SUD being admitted to intensive care units (ICUs) for an SUD-related condition or with SUD as a relevant comorbidity. Multiprofessional providers of critical care should be familiar with these disorders and their impact on critical illness. Management of critically ill patients with SUDs is complicated by both acute exposures leading to intoxication, the associated withdrawal syndrome(s), and the physiologic changes associated with chronic use that can cause, predispose patients to, and worsen the severity of other medical conditions. This article reviews the epidemiology of substance use in critically ill patients, discusses the identification and treatment of common intoxication and withdrawal syndromes, and provides evidence-based recommendations for the management of patients exposed to chronic use.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest, Funding: Please see DISCLOSURES at the end of this article.

References

    1. Westerhausen D, Perkins AJ, Conley J, Khan BA, Farber M. Burden of substance abuse-related admissions to the medical ICU. Chest. 2020;157:61–66.
    1. Tollisen KH, Hadley CL, Bjerva M, et al. Clinical impact of chronic substance abuse in a Norwegian ICU-population. Acta Anaesthesiol Scand. 2021;65(4):515–524.
    1. Cheng V, Inaba K, Johnson M, et al. The impact of pre-injury controlled substance use on clinical outcomes after trauma. J Trauma Acute Care Surg. 2016;81:913–920.
    1. Carvalho AF, Heilig M, Perez A, Probst C, Rehm J. Alcohol use disorders. Lancet (London, England). 2019;394:781–792.
    1. Fabbri A, Marchesini G, Morselli-Labate AM, et al. Blood alcohol concentration and management of road trauma patients in the emergency department. J Trauma. 2001;50:521–528.

MeSH terms