Substance abuse is common in our society, with a rise in the use of all forms of drugs. In the United States, the lifetime prevalence of alcohol abuse is 14%, and that of alcohol dependence is 8%.<sup>68 Robins L.N., Regier D.A.   Psychiatric Disorders in America: The Epidemiologic Catchment Area Study New York: The Free Press (1991). 

Cliquez ici pour aller à la section Références</sup> Since 1989, the worldwide production of heroin has risen, and opioid use also has increased dramatically. It is estimated that there are 1.5 million chronic heroin users nationwide, and with this the number of overdoses and deaths from heroin use has also risen.<sup>32 Hamid A., Curtis R., McCoy K. , et al. The heroin epidemic in New York City: Current status and prognoses J Psychoactive Drugs 1997 ;  29 : 375-391

Cliquez ici pour aller à la section Références</sup> The total economic cost of alcohol and other drug abuse in the United States is enormous, with alcohol abuse accounting for $99 billion per year and $67 billion for other drugs of abuse.<sup>43 Lewis D.C. The role of the generalist in the care of the substance-abusing patient Med Clin North Am 1997 ;  81 (4) : 831-844

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The emergency physician must confront all aspects of substance use, including acute intoxication, concurrent illnesses or trauma, and related social problems, such as unemployment, violent crime, and homelessness. The abrupt cessation or reduction of these drugs that occurs when patients present to the hospital with intoxication, illness, or trauma, or secondary to financial or social factors, can precipitate substance withdrawal. Any of these encounters provides an opportunity for intervention, prevention, and management of substance withdrawal.