Illicit Drugs and Candidates for Endoscopy and Surgery

Illicit drug use (IDU) is increasingly encountered in the procedural setting. Patients using illicit drugs acutely and chronically are at increased risk of adverse outcomes for endoscopy and surgery due to drug interactions with anesthesia. There is limited evidence-based guidance on managing this patient population in emergent and elective settings. Procedures are often canceled, creating delays in care, increasing healthcare expenses, and causing patient frustration. There is growing data to suggest that non-toxic patients may safely undergo procedures despite the recency or chronicity of IDU. Providers would benefit from guidance for managing these cases. Here we discuss the systemic effects of frequently encountered illicit drugs and procedural management considerations.