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ADA practical guide to substance use disorders and safe prescribing
Practical guide to substance use disorders and safe prescribing
ADA American Dental Association practical guide to substance use disorders and safe prescribing
"This is in addition to a variety of legal regulations dentists must follow regarding the storage and record keeping of controlled substances"--Provided by publisher.
Dentists have been inundated by patients with an array of complicated medical conditions and pain/sedation management issues. This is in addition to a variety of legal regulations dentists must follow regarding the storage and recordkeeping of controlled substances. Avoid unknowingly putting your practice at risk by becoming victim to a scam or violating a recordkeeping requirement with The ADA Practical Guide to Substance Use Disorders and Safe Prescribing. This Practical Guide is ideal for dentists and staff as they navigate:; Detecting and deterring substance use disorders (SUD) and drug diversion in the dental office (drug-seeking patients); Prescribing complexities; Treating patients with SUD and complex analgesic and sedation (pain/sedation management) needs and the best use of sedation anxiety medication; Interviewing and counselling options for SUD; Federal drug regulations Commonly used illicit, prescription, and over-the-counter drugs, as well as alcohol and tobacco, are also covered. Special features include:; Clinical tools proven to aid in the identification, interviewing, intervention, referral and treatment of SUD; Basic elements of SUD, acute pain/sedation management, and drug diversion; Summary of evidence-based literature that supports what, when and how to prescribe controlled substances to patients with SUD; Discussion of key federal controlled substance regulations that frequently impact dental practitioners; Checklists to help prevent drug diversion in dental practices; Chapter on impaired dental professionals; Case studies that examine safe prescribing and due diligence. - Publisher.
The ADA Practical Guide to Substance Use Disorders and Safe Prescribing -- Contents -- Contributors -- Preface -- Acknowledgments -- 1 Substance Use Disorders, Drug Diversion, and Pain Management: The Scope of the Problem -- Introduction -- Definitions -- Acute Pain -- Addiction -- Chronic Pain -- Drug Diversion -- Drug Misuse -- Opiates and Opioids -- Prescriber-Patient Mismatch -- Substance Abuse -- Substance Dependence -- Substance Use Disorders -- Substance Use Disorder, Drug Misuse, Drug Diversion, and Pain Management in the Dental Community -- Substance Use Disorder -- Medication Misuse -- Alcoholism -- Drug Diversion -- Pain Management in Dentistry -- Understanding the Cultures of Substance Use Disorder, Drug Misuse, and Drug Diversion -- The Sharing Culture -- The Income-driven Culture -- The Substance Abuse Culture -- The Addiction Culture -- Combinations of Cultures -- Summary -- References -- 2 Understanding the Disease of Substance Use Disorders -- Introduction -- Definitions -- Addiction -- Ambivalence -- Cross-addiction -- Medication-assisted Therapy -- Medical Model -- Psychological Therapy or Psychotherapy -- Tolerance -- Transtheoretical Model of Change -- Withdrawal -- Epidemiology: Drug/Alcohol -- Age and Gender -- Treatment -- Pathophysiology/Brain Pathways -- Signs, Symptoms, Behavior -- Alcohol -- Benzodiazepines -- Opioids -- Stimulants -- Cannabis -- Nicotine -- Hallucinogens, Designer Drugs, Inhalants -- Treatment Methods -- Behavioral Modifications and Counseling -- Medications for Substance Use Disorder -- Alcohol -- Benzodiazepines -- Opioids -- Stimulants, Hallucinogens, Cannabis, Inhalants -- Tobacco -- Summary -- Appendix 2.A: Common Opioid Analgesics and their Brand Names -- References -- Resources and Further Readings -- 3 Principles of Pain Management in Dentistry -- Introduction -- Definitions.
Neuropathic Pain -- Nociceptive Pain -- Neurophysiology and Neuroanatomy of Acute Inflammatory Pain -- Orally Administered Analgesic Agents -- Nonopioid Analgesics -- Adverse Drug Reactions and Toxicities of Nonopioid Analgesics -- Opioid Analgesics -- Side Effects of and Drug Interactions Associated with Opioid Analgesics -- Medication-Assisted Therapies for Treating Drug-Dependent Patients -- Adjunctive Drugs Used to Limit Pain in Dentistry -- Long-Acting Local Anesthetics -- Preemptive Analgesics -- Corticosteroids -- Guidelines for Analgesic Therapy -- Summary -- References -- Resources and Further Readings -- 4 Special Pain Management Considerations: (1) Chronic Methadone, Buprenorphine, and Naltrexone Therapy -- (2) Chronic Opioids for Nonmalignant Pain -- Introduction -- Definitions -- Opioid Maintenance Therapy -- Pseudo-addiction -- Hyperalgesia -- Cross-tolerance -- Interviewing the Patient: Establishing Goals of Treatment -- Pharmacological Treatment of Opioid Addiction -- Goals of Treatment -- Pharmacological Considerations of Methadone and Buprenorphine -- Treating Acute Dental Pain -- Acute Pain in Patients Receiving Opioid Maintenance Therapy -- Methadone and Buprenorphine -- The Active Opioid Addict -- Acute Pain Management in Patients Receiving Naltrexone Therapy -- Acute Pain Management in Patients Receiving Opioids for Chronic Pain -- Summary -- References -- 5 Sedation and Anxiolysis -- Introduction -- Definitions -- Spectrum of Anesthesia and Sedation -- Rescue -- Preoperative Evaluation -- Physical Status Classification -- Sedation -- Medications Available for Sedation of Patients with Substance Use Disorder -- Nitrous Oxide-Oxygen Sedation -- The Benzodiazepines -- Opioids -- Chronic Pain or Opioid-Based Maintenance Programs -- Ketamine -- Propofol -- Antihistamines -- Alpha Agonists.
Inhalation Anesthetics and Neuromuscular Blocking Drugs -- Inhalation Agents -- Local Anesthetics -- The Concept of Balanced Anesthesia -- Monitoring and Documentation -- Emergencies -- Special Considerations -- Summary -- Disclaimer -- References -- Resources and Further Readings -- 6 Common Substances and Medications of Abuse -- Introduction -- Definitions -- Drug Misuse -- Opiates and Opioids -- Prescription Drug Abuse -- Substance Abuse -- Substance Use Disorder -- Tolerance -- Visual Analog Pain Scale -- Signs and Symptoms of Substance Use Disorder -- Common Substances of Abuse -- Stimulants -- Hallucinogens -- Opioids: Heroin and Opium -- Inhalants -- Central Nervous System Depressants -- Marijuana and Other -9-Tetrahydrocannabinol Derivatives -- Prescription Medications -- Opioids -- Stimulants: Methylphenidate and Amphetamine/Dextroamphetamine (Schedule II) -- Central Nervous System Depressants -- Barbiturates -- Antipsychotics -- Muscle Relaxants -- Anticonvulsants -- Other Agents -- Over-the-Counter Medications -- Dextromethorphan -- Antihistamines -- Pseudoephedrine -- Summary -- References -- Resources and Further Readings -- 7 Tobacco Cessation: Behavioral and Pharmacological Considerations -- Introduction -- Definitions -- Cognitive Coping -- Behavioral Coping -- Nicotine Replacement Therapy -- Spit Products -- Forms of Tobacco -- Oral Effects of Tobacco Use -- Dental Practitioner Management of Tobacco Use -- Brief Intervention: Ask-Advise-Refer -- Low Intensity: Motivate-Educate-Refer -- Moderate Intensity: Create a Plan -- Spit Tobacco Interventions -- Gradual Reduction -- Oral Substitutes -- Social Support/Disapproval -- Medication Management for Smoking Cessation -- The Role of Nicotine -- Pharmacotherapy Options -- First-Line Agents -- Second-Line Agents -- Other Non-FDA-Approved Smoking-Cessation Therapies -- Summary.
Prescription -- Practitioner -- Dispense -- Readily Retrievable -- Due Diligence -- Common Violations by Dental Practitioners -- Scope of Practice -- Record Keeping -- Storage of Controlled Substances -- Disposal of Controlled Substances -- Documentation -- Surviving a Drug Enforcement Administration Inspection -- Practice Due Diligence Program -- Management of Noncontrolled Substances in the Office -- Summary -- Resources and Further Readings -- 11 Addiction and Impairment in the Dental Professional -- Introduction -- Definitions -- Addiction -- Impairment -- Denial -- The Complexity of Addiction -- The Neurobiology ofAddiction -- The Stigma of Addiction -- Epidemiology of Addiction in Dentistry -- Risk Factors for Substance Use Disorder -- Family History of Substance Use Disorder -- Stress -- Other Risk Factors -- Substances of Choice -- Identifying Addiction -- The Conspiracy of Silence -- Intervention -- Goals of Intervention -- Evaluation/Assessment -- Treatment -- Family and Staff -- Relapse -- Monitoring -- Peer Assistance or Dental Well-being Committee Programs -- Addiction Support Programs and Information -- Self-report Programs -- Consent or Mandated Programs -- Contractual Agreements with Peer Assistance or Well-being Committee Contracts -- Summary -- References -- Resources and Further Readings -- 12 Due Diligence and Safe Prescribing -- Introduction -- Definitions -- Due Diligence -- Relapse -- Prescriber-Patient Analgesic Mismatch -- Case Scenarios -- Recognition of Diversion Behaviors -- Ethics and Analgesia -- Alcohol and Benzodiazepines -- Opioid Maintenance Treatment and Acute Analgesia -- Stimulants and Tooth Pain -- Acute on Chronic Pain Management -- Alcoholism with Liver Disease -- Controlled-Substance Prescribing Regulations -- Impaired Professional -- Summary -- References -- Continuing Education Examination -- Index.
edited by Michael O'Neil, PharmD Professor and Vice-Chair, Department of Pharmacy Practice Drug Diversion, Substance Abuse, Pain Management Consultant South College School of Pharmacy, Knoxville, TN, USA.
Includes bibliographical references and index.
Hoboken, New Jersey : John Wiley and Sons Inc., [2015]
Practical guide series (American Dental Association)