ABSTRACT
Disulfiram implants are pharmacologically unreliable but extremely effective in some patients. The liaison psychiatrist must always be alert to the possibility that alcohol is partly or wholly responsible for a patient's symptoms. Chronic tension and anxiety states underlie alcohol abuse, and again, when the patient is clear of the direct effects of alcohol, the psychiatric disorder should receive attention. In casual, social, regular or excessive use, alcohol has a potential for interaction with commonly used drugs, of which the liaison psychiatrist must be aware. Narcotic analgesics, despite their addictive potential, may cause, among various psychiatric upsets, depression. Chronic minor analgesic abuse may be suspected from tremor, ataxia, tinnitus, hyperventilation and such psychiatric effects as impaired memory, paranoia and visual hallucinations. The psychiatrist may be asked to advice on the management of a patient claiming to be a regular user. An additive pharmacodynamic interaction is usual; in the case of diazepam the result is synergistic and more dangerous.
