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Hospital Discharge Report
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Synthesis
Substance dependence, treated and stabilised
Hospital course note
Dear colleague, I am writing to inform you regarding the discharge of your 75-year-old
male patient, admitted on 20/02/2021 due to substance dependence. Upon admission,
a comprehensive psychiatric and medical assessment was conducted, confirming polysubstance
dependence syndrome. Withdrawal monitoring was initiated immediately, with close observation
for complications including delirium and seizure risk. The patient received structured
detoxification support, pharmacological withdrawal management, and nutritional supplementation.
Psychological counselling sessions were provided alongside motivational intervention.
Social work assessment was completed to evaluate home circumstances and support needs.
The patient remained medically stable throughout and was discharged on 28/02/2021
in a treated and stabilised condition. We recommend close follow-up in primary care,
referral to community substance misuse services, and continued monitoring of physical
and mental health. Medication details are enclosed. Please do not hesitate to contact
us should you require further information.
Diagnosis at Discharge
| Mental and behavioural disorders due to multiple drug use – dependence syndrome | 28-Feb-2021 | active |
Significant procedures
| Discharge planning and community referral | 27-Feb-2021 | - |