Substance Misuse - When should I prescribe?

Deciding whether to prescribe

Before deciding whether to prescribe, you need to be clear about the functions of a prescription. A prescription can:

• reduce or prevent withdrawal symptoms;
• offer an opportunity to stabilise drug intake and lifestyle whilst breaking with previous illicit drug use and associated unhealthy behaviours;
• promote a process of change in drug taking and risk behaviour;
• help to maintain contact and offer an opportunity to work with the patient.

Only prescribe substitute drugs if:

• drugs are being taken on a regular basis, particularly daily misuse;
• there is convincing evidence of current dependence (including objective signs of withdrawal symptoms wherever possible);
• the patient is motivated to change at least some aspects of their drug use;
• the assessment (history, urine toxicology) clearly substantiates the need for treatment;
• you are satisfied that the patient will co-operate and demonstrate adequate compliance with the prescribing regime.

Treating different drug misusers

Different drug misusers need different approaches. As well as opiates, you may come across misuse of the following:

• amphetamines;
• cocaine;
• benzodiazepines;
• volatile substances;
• alcohol and drugs.

On to:       Setting goals

Back to:    Substance misuse Home Page

Written by:    Michael Harris

Last update: 07 May 2007

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