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.

References -- Resources and Further Readings -- 8 Detection and Deterrence of Substance Use Disorders and Drug Diversion in Dental Practice -- Introduction -- Definitions -- Drug Diversion -- Doctor or Dentist Shoppers -- Screening Patients for Substance Use Disorder -- Screening, Brief Intervention, Referral for Treatment -- CAGE-AID -- The National Institute of Drug Abuse Drug Use Screening Tool: NMASSIST -- Schemes and Scams to Obtain Prescription Drugs -- Patient Diversion Behaviors in the Office -- Prevention Practices -- Patient Diversion Behaviors Outside the Office -- Dental Practitioner- and Office Personnel-Related Prescription Drug Diversion -- Prescription Drug Monitoring Programs -- Case Study: Review of a Prescription Drug Monitoring Program Report -- Reporting of Violations or Suspected Criminal Behavior -- Patient Privacy -- Access to Prescription Drug Monitoring Program Database -- Prescriber Controlled-Substance Reports -- Disposal of Controlled Substances -- Universal Precautions in Prescribing Controlled Substances -- Summary -- References -- Resources and Further Readings -- 9 Interviewing and Counseling Patients with Known or Suspected Substance Use Disorders: Dealing with Drug-seeking Patients -- Introduction -- Definitions -- Drug-seeking Patient -- Motivational Interviewing -- Patient-centered Approach -- Active Listening -- Prescription Drug Monitoring Programs -- Preinterview Considerations -- Patient Interview Considerations -- Interviewing and Counseling Techniques -- What Questions Should Be Asked? -- Screening Tools -- Screening, Brief Intervention, Referral to Treatment -- CRAFFT -- Alcohol Use Disorders Identification Test -- Documentation -- Summary -- References -- Resources and Further Readings -- 10 Office Management of Controlled Substances -- Introduction -- Federal Statutes and Regulations -- Definitions.

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.

EULA.