Practicing good medicine at the present time requires psychiatrists to maintain a high index of suspicion in order to rule out SLID intoxication, when treating conditions as anxiety, depression and psychotic disorders.
SLID stands for synthetic legal intoxicating drugs, that have been banned in US but continued to be manufactured at an worrisome rate with just slightly modified variants.
The sad part is that most regular urine drug screens do not test for synthetic marijuana, therefore a patient who complains of severe anxiety, panic attacks not responding to the usual treatment could be very well showing the symptoms of SLID. These patients are willing to take a regular urinary drug screen while denying the use of marijuana. The psychiatrist is left with a puzzle to solve, sometimes with no hope for an answer, unless he is aware of this increasing trend.
How about ‘ bath salts’? The most common compound in them is mephedrone or 3,4- methylenedioxypyrovalerone (MDPV), producing effects similar to those of methamphetamines. The most common symptoms that should alert the clinician to the possible use of bath salts are : agitation, aggression, anxiety, confusion, and acute psychosis. The urine drug screen should be testing for cathinones, or otherwise the clinical picture could be misdiagnosed as another case of ‘ resistant to treat’ mental illness.
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