Dr Alistair Dunn Lead Clinician Northland Health Community Mental Health & Addictions Northland DHB Whangarei 8:30 - 9:25 WS #147: The Bottom Line; Tackling the Problem of Prescribed Drug Addiction 9:35 - 10:30 WS #157: The Bottom Line: Tackling the Problem of Prescribed Drug Addiction (Repeated)
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Dr Alistair Dunn - GP CME South/Sun_Room6_0830 Dunn... · Longer term : NAH > memory loss / cog impairment ... Oh well , if you must ….. Look before you leap Easy to start > Hard
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Dr Alistair DunnLead Clinician
Northland Health Community Mental Health &
Addictions
Northland DHB
Whangarei
8:30 - 9:25 WS #147: The Bottom Line; Tackling the Problem of Prescribed Drug Addiction
9:35 - 10:30 WS #157: The Bottom Line: Tackling the Problem of Prescribed Drug Addiction
(Repeated)
The Bottom Line :
Prescribed Controlled Drug
Addiction
Dr Alistair Dunn
Controlled Drugs ?
Controlled Drugs ?
Class A : very high risk
Class B : high risk
Class C : moderate risk
Controlled Drugs
Class A
Cocaine, LSD , Heroin Methamphetamine , Mescaline
Controlled Drugs
Class A Cocaine, LSD , Methamphetamine Rx Heroin
Class B Hashish , MDMA , opium , GHB
Rx CD PAD morphine , fentanyl , methadone Methylphenidate
Controlled Drugs
Class A Cocaine, LSD , Methamphetamine Rx Heroin
Class B Hashish , MDMA , opium , GHB Rx CD PAD morphine , fentanyl , methadone Methylphenidate
of the Act prohibits prescribing a controlled drug to a person whom the prescriber believes to be dependent on that or any controlled drug, unless that prescriber:
is a gazetted practitioner; or
is working in a gazetted agency; or
has an authority to prescribe for a particular patient.
M.O.D.A.
Case #1 :morphine 50 mg bi d
Case #2 : diazepam 5mg tds
Prescribed Controlled Drugs
Opiates & Benzodiazepines
Prescription Opiates
Prescription Opiates
Morphine , Methadone , Fentanyl ,
Oxycodone ( @#$%^& !!!!!!!)
Codeine,DHC,panadeine,nurofen plus
Buprenorphine (Suboxone , Norspan)
Plus
Tramadol you betcha
OPIATE Dependence
All prescribed opiates can be addictive so TAKE CARE
OPIATE Dependence
Tolerance & Withdrawal
what else ?
DSM criteria :
OPIATE Dependence
Tolerance & Withdrawal
Dyscontrol
Salience
Craving
Continued use despite adverse consequences
Opiates are prescribed for PAIN
YEAH …….NAH
Opiates are prescribed for PAIN
Acute & short term : YEAH
Longer term : NAH
“There are no longitudinal RCTs on the long term effectiveness & consequences of opioid use in chronic non malignant pain”