Controlled substances have become problematic drugs in the US–but not just street drugs or the CS1 agents that we typically think of as being an issue.

Prescription drugs have become much more of a problem, leading to addiction, issues with substance abuse, and creating problems for prescribers as well–how can a prescriber best treat a patient when it may be difficult to determine patient motives for treatment?

We all know of stories of CS prescribing or use that is inappropriate. Cases where parents of pediatric patients receiving opioids take the medication themselves, for instance.

Or of patients “doctor shopping” for multiple prescriptions. In the state of Alabama, it is estimated that for every 100 residents, there are 143 prescriptions for opioids. The southeast in general has a reputation for overprescribing these medications.

I put this forum in unit 4 as a reminder–not all CS are opioids. Remember that certain steroid hormones, diet medications, stimulants, drugs for insomnia, drugs for seizures and anxiety also fall under the CS classifications. So even if you do not see yourself as prescribing opioids in the near future or any future, you may still prescribe some of the “other” CS that have gains that make them attractive to patients.

— In this forum, share your thoughts on opioid or other CS prescribing or over-prescribing If you have clinical experience with this issue and want to share or comment on this, feel free to do so. What do you think can be done to limit over-prescribing of these drugs?

What can be done for patients who become problematic? If you see yourself working in a practice where you may prescribe CS, do you have an idea of how you would work with “difficult” patients? After you post, you will be able to comment on and cross-post to comments posted by your classmates.