Substance use disorders

Drug misuse is widespread in the UK and causes significant health morbidity and mortality. In 2009/10, in England and Wales, 8.6% of adults (aged 16–59) had used an illicit drug in the past year, 3.1% used a class A drug, and cannabis was the drug type most likely to be used. In the same period, there were 5809 hospital admissions with a primary diagnosis of drug-related disorder. In addition, there were 1738 drug-related deaths. For people in treatment for drug addiction, 50% were using heroin only, and a further 31% were using heroin and crack cocaine. It is clearly important to know how to assess and manage substance use disorders, and in particular to know about the treatments for heroin addiction.In this article we examine the principles of identifying and managing drug addiction, and consider in some detail the presentation, risks and harms, and treatment for misuse of opioids, stimulants, benzodiazepines, cannabis and legal highs/party drugs, which constitute the main classes of substance misused in the UK.