Primary care of parenteral substance abusers.

Parenteral substance abuse is widespread. Although treatment for opiate dependence and cocaine abuse takes place in specialized programs, abusers frequently present in primary care settings for management of associated health problems. This article reviews the two drugs that are most commonly abused parenterally (heroin and cocaine); treatment options, including methadone maintenance and narcotic antagonists; and the primary care and health maintenance issues of this population. Psychological aspects of caring for these patients are discussed. Physical findings and diagnosis and management of the complications of parenteral drug abuse are presented.