# Polysubstance-Induced Hepatotoxicity and the Role of Supportive Management

## TL;DR

This paper discusses liver injury caused by multiple drug use and shows that supportive care can help, even without a specific drug.

## Contribution

The paper presents a novel case of DILI from illicit drug use managed without NAC.

## Key findings

- A 29-year-old female with polysubstance-induced liver injury improved with supportive care.
- N-acetylcysteine was not used in this case, yet the patient showed gradual improvement.
- This case highlights the potential for supportive management in DILI from illicit drugs.

## Abstract

With the continued rise of polysubstance use throughout the country, it has been shown to affect a multitude of organ systems. Drug-induced liver injury (DILI) has been widely documented in its association with salicylates or acetaminophen and the utility of using N-acetylcysteine (NAC) for its hepatoprotective effects. However, DILI caused by illicit drug use and guideline-directed management has had little research. We present the case of a 29-year-old female who presented with altered mental status. She was found to have a concomitant liver injury and was treated supportively without the use of NAC, with gradual improvement.