Bromureide Dependence in Alcoholics

In a retrospective study, coincident or alternating dependence on bromureides was found in 8·7% of all patients who attended a general hospital clinic for the treatment of alcoholism between 1964 and 1969. Seventy-eight out of 87 patients used freely available counter preparations of bromureides. This dependence, particularly upon the freely available preparations, occurred more frequently in women than in men, and more often in patients from lower socio-economic levels. Six of the 87 patients presented because of an acute overdose after prolonged ingestion of smaller amounts of bromureides. Of the remainder, 34 had neuropsychiatric changes consistent with chronic bromureide intoxication, and in the majority of cases estimations of serum bromide levels confirmed the diagnosis. When the bromureide-dependent patients presented, they showed more deterioration than alcoholics of comparable social levels who did not abuse bromureides. There was no evidence, however, in their childhood histories, of greater family disruption which might have predisposed to the development of more abnormal or inadequate personalities. It is suggested that bromureide dependence and consequent bromide intoxication prejudice the chances of improvement in alcoholics who develop this second form of drug abuse. Unfortunately, the patients who are most likely to misuse bromureides as well as alcohol are those who socio-economically can least afford a further handicap in their recovery.