Drug Abuse, Prescription

Matthew A. Silva, BCPS, RPh, PharmD and Hilary Mislan, MD Reviewed 06/2022

BASICS

Controlled substances are prone to misuse and diversion. Universal precautions should be used for monitoring of all patients prescribed controlled substances to identify substance use disorder ...

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

Treatment with MAT should continue for as long as the patient benefits from it.

FOLLOW-UP RECOMMENDATIONS

Expert opinion suggests high frequency visits (such as weekly) when a patient begi...

REFERENCES

Onwuchekwa Uba R, Ankoma-Darko K, Park SK. International comparison of mitigation strategies for addressing opioid misuse: a systematic review. J Am Pharm Assoc (2003). 2020;60(1):195–204.

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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

Most licensed physicians and nurse practitioners may now provide MAT with buprenorphine without the requirement of special certification.
Conduct frequent UDSs (weekly to every 3 months...

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