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Substance Use Disorders

S. Lindsey Clarke, MD, FAAFP Reviewed 06/2020
 


BASICS

DESCRIPTION

Any pattern of substance use causing significant physical, mental, or social dysfunction 
  • Substances of abuse include:

    • Alcohol

    • Tobacco

    • Prescription medications

      • CNS depressants (barbiturat...

DIAGNOSIS

Substance use disorder (DSM-5 criteria): ≥2 of the following in past year severity based on number of criteria present: 
  • Missed work or school

  • Use in hazardous situations

  • Continued use despite ...

TREATMENT

Determine substances abused early (may influence disposition). 

GENERAL MEASURES

  • Nonjudgmental, medically oriented attitude

  • Motivational interviewing and brief interventions can overcome denial...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Initially frequent visits to monitor for medical stability and adherence and then progressive follow-up intervals 

Patient Monitoring

Verify patient’s adherence wit...

REFERENCES

1
Committee on Obstetric Practice. Committee Opinion No. 711: opioid use and opioid use disorder in pregnancy. Obstet Gynecol.  2017;130(2):e81–e94.
2
Smith PC, Schmidt SM, Allensworth-Da...

ADDITIONAL READING

Albertson TE, Chenoweth JA, Colby DK, et al. The changing drug culture: emerging drugs of abuse and legal highs. FP Essent.  2016;441:18–24. 

SEE ALSO

Alcohol Use Disorder (AUD);...

CODES

ICD10

  • F19.10 Other psychoactive substance abuse, uncomplicated

  • F10.10 Alcohol abuse, uncomplicated

  • F12.10 Cannabis abuse, uncomplicated

  • Z72.0 Tobacco use

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

CLINICAL PEARLS

  • Substance use disorders are prevalent, serious, and often unrecognized in clinical practice. Comorbid psychiatric disorders are common.

  • Substance abuse is distinguished by family, socia...

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