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

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.

Manchikanti L, Abdi S, Atlu...

ADDITIONAL READING

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...

Subscribe to Access Full Content

START 10-DAY FREE TRIAL

Subscribe Now

Forgot password?

Enter an Access Code

GET CME/CE