ABSTRACT
The incidence of substance misuse in the UK varies widely by geographical location. ‘Polysubstance’ misuse is the norm, and heavy alcohol consumption and tobacco smoking compound the harm done by classified drugs. Alcohol and marijuana have fundamental non-specific actions on the neural membrane, in common with the sedative–hypnotic–anaesthetic group of drugs. Alcohol withdrawal may result in blackouts, tremor, hallucinations, delirium and seizures. Drug abuse is associated with a wide range of health problems, which may present acutely to various different healthcare professionals. Drug abuse is often associated with poor diet, poor hygiene and generalised immunosuppression. Independent of any direct actions of the drug, pregnancy and neurodevelopmental outcomes are nevertheless poor and will improve only with better access to healthcare and social support. Pregnant women who use drugs may avoid antenatal care for fear of inciting closer scrutiny of their lifestyles, which may often include other criminal activities.
