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Substance misuse disorders on the psychiatric ward

The focus of this chapter is the management of substance misuse and addiction on the psychiatric ward in patients who have presented with a psychiatric disorder. Some patients will display other forms of addictive behaviour such as gambling, sexual activity, or Internet use. Where this is not the primary focus, the same principles of broad-based biopsychosocial management apply. There are a number of guidelines available, such as those from the Department of Health (the ‘Orange Book’) and the National Institute for Health and Care Excellence, and prescribing advice, such as the British Association for Psychopharmacology guidelines and The Maudsley Prescribing Guidelines in Psychiatry, that are useful references for the treatment of patients with substance misuse disorders and addiction. This chapter does not seek to replicate this advice, but does include useful and common scenarios that will be encountered on the general psychiatric ward.