By R. Maldonado (auth.), Prof. Dr. W. W. Fleischhacker, Prof. Dr. D. J. Brooks (eds.)

Substance-related problems pose an expanding problem not just to the sphere of psychiatry but additionally to public well-being. The fast improvement of our society has additionally replaced the face of substance use and abuse, either quantitatively and qualitatively. during this quantity overseas specialists current stories of the most recent learn masking many components starting from neurobiology to mental administration, in addition to diverse medicines, from alcohol to ecstasy.

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Clinical and analytical issues to be considered when choosing the appropriate alcohol marker for different purposes Comments Issue Acute and/or chronic drinking? - Time delay between drinking and sampling? Sensitivity, specificity, and predictive values? - Ease of use and availability? - Does testing aim to detect recent acute or chronic drinking and/or any harmful effects of long-term misuse? Should testing involve a single marker or a combination of complementary tests? What is the biological half-life of the marker?

What cut-off limit should be applied - should focus be on high sensitivity or high specificity? Does a positive test result need to be verified by a more specific confirmatory assay? Is the biological sample used for measurement easily accessible? Is testing performed at the clinical central laboratory, or does it require a special laboratory? What is the time to obtain the test result? What is the cost of testing? 28 A. Helander to improve the accuracy of alcohol markers for screening in unselected populations and follow-up of alcohol-dependent individuals during outpatient treatment.

Only exceptionally it is necessary to hospitalise a patient for determining the adequate dosage. Maintenance doses must be individually determined. The recommended medium range is between 60 and 100mg per day. The maximum dosages formulated for non-tolerant persons do not apply. The general rule is not to prescribe minimal or maximal doses but doses that are sufficient in order to avoid withdrawal symptoms. , 1998). On the other side, an individually inappropriate high dosage may also invite non-prescribed Benzodiazepine or illegal cocaine use.

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