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Substance Use Disorders

S. Lindsey Clarke, MD FAAFP and Benjamin J Velky, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

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

    • Alcohol

    • Tobacco

    • Prescription medications

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

  • Treatment should combine pharmacotherapy and cognitive behavioral therapy or another evidence-based modality su...

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. [View Abstra...

ADDITIONAL READING

SEE ALSO

Alcohol Use Disorder (AUD); Alcohol Withdrawal; Tobacco Use and Smoking Cessation 

CODES

ICD10

  • F18.951 Inhalant use, unspecified with inhalant-induced psychotic disorder with hallucinations

  • F11.120 Opioid abuse with intoxication, uncomplicated

  • F17.201 Nicotine dependence, unspecified, ...

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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