Anesthetic implications of substance abuse

Substance abuse has become an increasingly devastating problem in this country and abroad during the last two decades. Huge amounts of time and money have been devoted to the treatment and eradication of this widespread problem. Increasing media attention, brought about by the premature deaths of celebrated athletes, has served to increase the public's awareness of the problem. Substance abuse crosses all socioeconomic, gender and religious boundaries. In the pregnant patient, substance abuse affects not only the mother, but the unborn fetus as well. The effects of four commonly abused substances-alcohol, marijuana, cocaine and narcotics-on the mother and fetus will be examined, as well as the implications for anesthetists in administering safe anesthesia for these patients. Until we can educate the public and eradicate the problem of substance abuse in our society, we will continue to see patients involved with drugs. Awareness of the scope of the problem and the specific effects of the aforementioned drugs should help the anesthetist administer safe and effective anesthesia to substance abusers.