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Drug Abuse, Prescription

Pamela R. Tsinteris, MD, MPH and Matthew A. Silva, PharmD, RPh, BCPS Reviewed 06/2020
 


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

1
Smith PC, Schmidt SM, Allensworth-Davies D, et al. A single-question screening test for drug use in primary care. Arch Intern Med.  2010;170(13):1155–1160.
2
Manchikanti L, Abdi S, Atlu...

ADDITIONAL READING

SEE ALSO

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

  • Perform informed consent about all risks of controlled substances before starting and every 3 months while prescribing.

  • Conduct frequent UDSs (weekly to every 3 months) for all patients...

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