title: Prescription drug abuse: epidemiology, regulatory issues, chronic pain management with narcotic analgesics.
abstract: The epidemic of prescription drug abuse has reached a critical level, which has received national attention. This article provides insight into the epidemiology of prescription drug abuse, explains regulatory issues, and provides guidelines for the assessment and management of pain, particularly with long-term opioid therapy. Using informed consent forms, treatment agreements, and risk documentation tools and regularly monitoring the 4 A's help to educate patients and guide management based on treatment goals. By using universal precautions, and being aware of aberrant behaviors, physicians may feel more confident in identifying and addressing problematic behaviors.
authors.affiliation: Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 66, New York, NY 10032, USA; Departments of Family Medicine and Psychiatry, Columbia University, 710 West 168th Street, New York, NY 10032, USA. Electronic address: jmm2141@columbia.edu.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Manubay
authors.affiliation: The Columbia University Buprenorphine Program, Department of Psychiatry, Columbia University, 710 West 168th Street, 12th Floor, New York, NY 10032, USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Muchow
authors.affiliation: Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 66, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Sullivan
mesh_terms: D002908:Chronic Disease; D004282:Documentation; D004335:Drug and Narcotic Control; D006801:Humans; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D010147:Pain Measurement; D055553:Prescription Drugs; D011320:Primary Health Care / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D009294:Narcotics; D055553:Prescription Drugs