Abstract
The abuse and misuse of controlled substances (mostly opioids, but to a lesser extent benzodiazepines and stimulants) is a serious public health problem that is commonly encountered in primary care. Concerns about controlled substances include the potential for abuse, misuse, tolerance, and diversion, as well as iatrogenic effects. Long-term effectiveness of these substances is also not established. However, PCPs often feel pressure to prescribe them. This chapter provides an overview of the opioid abuse epidemic, including the scope of the problem and the roots of it, and also provides essential information about the properties of the various controlled substances.
The chapter also reviews ways a BHC can help a primary care clinic manage the risk of opioid abuse among patients. Strategies for helping include improving care for the underlying problems, developing and administering medication agreements, completing screenings to identify patients at risk for medication abuse, helping to oversee urine drug screen testing, developing registries and group visits to better structure care, and helping mediate PCP–patient conflicts over medications. Each of these strategies is discussed in detail.
“It is easy to get a thousand prescriptions but hard to get one single remedy.”
Chinese Proverb
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Robinson, P.J., Reiter, J.T. (2016). Prescription Drug Abuse in Primary Care. In: Behavioral Consultation and Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-319-13954-8_14
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DOI: https://doi.org/10.1007/978-3-319-13954-8_14
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