Detoxification or supervised withdrawal

Abstract In 2016, 38% of surveyed state and federal prisoners reported using illegal drugs, and 30% reported using alcohol at the time of their offense. These are likely significant underestimations of the true number of persons who were under the influence when they were arrested, highlighting the necessity of screening for both intoxication and risk of withdrawal from substances during the initial intake process upon arrival to a correctional facility. The clinician faces an imposing challenge to accurately assess underlying psychopathology while the patient is amid acute intoxication or withdrawal. This chapter reviews the typical presentations of intoxication and withdrawal of several common substances, as well as their medical management, assisting in the determination as to whether maintenance medication is to be initiated or not. The similarities and distinctions of such syndromes with other mental illnesses are also discussed.