Canadian Journal of Anesthesia, Vol 19, 461-477, Copyright © 1972 by Canadian Anesthesiologists' Society

Anaesthetic Problems due to Drug Abuse and Dependence

¹ Department of Anaesthesia, Faculty of Medicine, University of British Columbia;Department of Anaesthesia, Vancouver general Hospital

New concepts have recently developed, in the consideration of Drug Abuse³ (Non-medical Use of Drugs) not only in alterations of terminology but also in the depth and variety of understanding of the pharmacological and social problems that accompany the currently prevalent trend to increase of such abuse of drugs.

Because of this trend, there is an increasing likelihood that the practicing anaesthetist will be faced with patients who have taken drugs prior to coming to surgery and anaesthesia in a way which would be considered abuse of these substances.

There are problems from drug abuse in association with anaesthesia. The anaesthetist may have not only the problem of identifying the abuser but also of identifying the type of drug he abuses and its anaesthetic implications. These implications generally fall into seven main aspects:

(1) Personal injury (self and O.R. personnel)

(2) Withdrawal syndromes: Unrecognized or improperly managed.

(3) Interactions of abused drugs with anaesthetics and adjunctive drugs.

(4) Tolerance.

(5) Dependence: latrogeneic, induced by the liberal, prolonged, or injudicious use of stimulants or depressants.

(6) Organic changes; chronic intake.

(7) Complications of the needle.