Introduction

Substance intoxication is a transient condition of altered consciousness and behavior associated with recent use of a substance. It is often maladaptive and impairing, but reversible. If the symptoms are severe, the term "substance intoxication delirium" may be used. Substance intoxication may often accompany a substance use disorder (SUD); if persistent substance-related problems exist, SUD is the preferred diagnosis.

Slang terms include: getting high (generic), being stoned, cooked, or blazed (usually in reference to cannabis) and many more specific slang terms for particular intoxicants. Alcohol intoxication is graded in intensity from buzzed, to tipsy (all the way up to drunk, hammered, smashed, wasted, destroyed, shitfaced and a number of other terms).

Clinical description

A transient condition following the administration of alcohol or other psychoactive substance, resulting in disturbances in level of consciousness, cognition, perception, affect or behaviour, or other psychophysiological functions and responses.

This should be a main diagnosis only in cases where intoxication occurs without more persistent alcohol- or drug-related problems being concomitantly present. Where there are such problems, precedence should be given to diagnoses of harmful use, dependence syndrome, or psychotic disorder.

Diagnostic criteria for research

Acute intoxication is usually closely related to dose levels. Exceptions to this may occur in individuals with certain underlying organic conditions (e.g. renal or hepatic insufficiency) in whom small doses of a substance may produce a disproportionately severe intoxicating effect. Disinhibition due to social context should also be taken into account (e.g. behavioural disinhibition at parties or carnivals). Acute intoxication is a transient phenomenon. Intensity of intoxication lessens with time, and effects eventually disappear in the absence of further use of the substance. Recovery is therefore complete except where tissue damage or another complication has arisen.

Symptoms of intoxication need not always reflect primary actions of the substance: for instance, depressant drugs may lead to symptoms of agitation or hyperactivity, and stimulant drugs may lead to socially withdrawn and introverted behaviour. Effects of substances such as cannabis and hallucinogens may be particularly unpredictable. Moreover, many psychoactive substances are capable of producing different types of effect at different levels. For example, alcohol may have apparently stimulant effects on behaviour at lower dose levels, lead to agitation and aggression with increasing dose levels, and produce clear sedation at very high levels.

Some people are more prone to intoxication than others. For instance, someone who is a heavy drinker may be able to ingest much larger quantities than a light drinker without being intoxicated. Other factors impacting intoxication include:

Medications: Certain medications can enhance the effect of alcohol and increase intoxication. Sedative drugs, such as those for anxiety or mood disorders, can be extremely dangerous if combined with alcohol.6

Medical conditions: Certain medical conditions can make you more susceptible to intoxication. Before drinking, talk to your doctor about potential risks and how much alcohol is considered safe.

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Regards

Mary Wilson

Editorial office

Clinical Pharmacology and Toxicology Research

E-mail: pharmatoxicol@eclinicalsci.com