MANAGEMENT OF HOSPITALIZED INTRAVENOUS-DRUG-USERS - ROLE OF THE INTERNIST

Intravenous drug users present significant clinical challenges to inte rnists. In this paper, we review common clinical dilemmas faced by int ernists when managing intravenous drug users in the inpatient hospital setting. Articles were identified through a MEDLINE search and biblio graphies of published articles. Studies and reviews were selected for information relevant to the management of hospitalized intravenous dru g users. Seventy-three papers were selected for this review. We summar ize data and information from the relevant literature concerning commo n presenting medical problems (fever, musculoskeletal pain, and dyspne a), the importance of knowing patients' HIV status, common behavioral issues, special concerns of women, and the diagnosis and management of drug withdrawal in intravenous drug users. We also offer recommendati ons for hospital discharge planning. With appropriate knowledge of the epidemiology and management of important medical and substance use pr oblems among intravenous drug users, internists may more effectively c are for them in the hospital setting.