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Drug Abuse, Prescription

Pamela Tsinteris, MD, MPH and Matthew A. Silva, PharmD, RPh, BCPS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Prescription drug abuse behaviors exist on a continuum and may include:

    • Use of medication for nonmedical reasons such as to get high or enhance performance

    • Use of medication for medi...

DIAGNOSIS

  • Initial screening: “How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?”; primary care setting sensitivity of 100% and spe...

TREATMENT

Addiction is a treatable chronic disease. The general approach to treatment includes inpatient, residential, or outpatient detoxification as required; counseling and intensive counseling as ...

ONGOING CARE

PATIENT EDUCATION

  • Controlled medication should be inaccessible to others (ideally in locked box/bag). Diverting medication may result in legal charges. Patients should be aware of addictio...

REFERENCES

1
1 Frank JW, Lovejoy TI, Becker WC, et al. Patient outcomes in dose reduction or discontinuation of long-term opioid treatment: a systematic review. Ann Intern Med.  2017;167(3):181–19...

CODES

ICD10

  • F19.10 Other psychoactive substance abuse, uncomplicated

  • F11.10 Opioid abuse, uncomplicated

  • F15.10 Other stimulant abuse, uncomplicated

  • F13.10 Sedative, hypnotic or anxiolytic abuse, uncomplic...

CLINICAL PEARLS

  • Education and PMPs help prevent prescription drug abuse.

  • Standardized office practice agreements can help manage controlled substance prescriptions.

  • A single effective screening question...

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