AIDS and drug abuse: some aspects of psychiatric consultation
Musacchio de Zan, A.; D'Agnone, O.A.
Medicine and Law 8(2): 119-123
1989
ISSN/ISBN: 0723-1393 PMID: 2516587 Document Number: 378907
The rapidly rising number of HIV-infected intravenous drug users in Buenos Aires has produced unprecedented difficulties in the physician-patient relationship and a need for greater involvement on the part of mental health specialists. At present, 35% of these drug users are HIV-positive. When hospitalized for various medical complications of the virus, drug users often manifest acting out behaviors, denial of their addiction, and other psychopathic personality traits. They are likely to be noncompliant with treatment regimens and demanding of special treatment from hospital staff. In many cases, physicians seek to protect themselves from involvement with these difficult, highly anxious patients by making a referral to a psychiatrist. Although such a referral is usually appropriate, physicians should seek to work through the crisis in the physician-patient relationship and address psychosocial as well as medical issues. Failure on the part of the physician to navigate the initial disorganizing crisis and symbiotic stages can produce serious depression in the patient, a sense of abandonment, and a worsening of the medical condition.