What are the various schedules of medications for controlled substances?

What are the various schedules of medications for controlled substances?
Peer 1

Discussion 1

What would you do first prior to prescribing any medication? I would need to perform a comprehensive exam including medication history Before prescribing any medication a screening for dependency needs to be initiated. Due to Howard having a history of chronic pain which relates to a history of a high doses of opioids. Next, I would perform a urine drug screening, a DAST-20 screening, and CAGE-AID.

What are the various schedules of medications for controlled substances? The various schedules of medications for controlled substances are:

Schedule I- have no accepted medical use and high potential for abuse for example: Ecstasy, heroin, and LSD

Schedule II- have high potential for abuse and may lead to severe psychological or physical dependence. For example: hydromorphone ( Dilaudid), methadone (Dolophine), meperidine (Demerol), oxycodone (OxyContin, Percocet), and fentanyl (Sublimaze, Duragesic). Other schedule II narcotics include: morphine, opium, codeine, and hydrocodone

Schedule III- moderate to low abuse potential are Codeine, Buprenorphine and Ketamine( Addiction Center, 2021)

Schedule IV- Consider by the DEA to have an accepted medical use and a lower potential of abuse. They are: Xanax, Valium, Ativan, Librium, Ambien, Sonata, Tramadol, and Lunesta(Addiction Center, 2021)

Schedule V-Lowest potential. Are: Robitussin AC, a cough suppressant with a very low amount of Codeine(Addiction Center, 2021)

Would you prescribe a long or short acting narcotic? Why or why not? I would prescribe a short acting narcotic. A short acting narcotic is more appropriate for transient pain types, like acute, breakthrough, or chronic intermittent pain, therefore require long lasting analgesia. The patient does state his pain flairs up which is described as chronic intermittent pain. Short acting narcotics are often referred to immediate-release opioids, improve function, and fewer adverse effect than long-acting narcotics (Smith, 2012)

Discussion 5

What type of substance abuse programs would be most appropriate for him?

Medication-assisted therapy (MAT) which includes medicines, counseling, and behavioral therapies. Medications are administered, dispensed, and prescribed in various settings such as a SAMHSA-accredited and certified opioid treatment program (OTP) or certified practitioners depending on medication. This offers a whole patient approach to treatment which can increase your chance of a successful recovery (MedlinePlus, 2020)

What requirements are there for a nurse practitioner to prescribe a medication to treat opioid addiction? Nurse practitioners may take both 8 hour DATA-wavier course for treatment of opioid use disorder, formulated by national experts that physicians take, and the additional 16 hours course offered for free by SAMHSA through the providers clinical support system. For Nurse practitioners who have completed training that’s required will be given a DATA-wavier for up to 30 patients and will be able to prescribe immediately.

What are the requirements for a patient who is enrolled in a medication assisted opioid treatment program?

Patients who are enrolled in a medication assisted opioid treatment program are required to meet with a clinician for a physical examination and drug tests and agree to a treatment plan. The patient is required to keep all appointments, agree to drug testing on a regular basis, take medications as prescribed, and to avoid any person or place that may cause a relapse.

Addiction Center (2021) Controlled substances act and scheduling. Retrieved: October 21, 2021. From: https://www.addictioncenter.com/addiction/controlled-substances-act-and-scheduling/

MedlinePlus (2020) Opioid misuse and addiction treatment. Retrieved: October 21, 2021. https://medlineplus.gov/opioidmisuseandaddictiontreatment.html

Smith H. S., (2012) Rapid onset opioids in palliative medicine. Annals of Palliative Medicine.1(1),45-52. Doi: 10.3978/j.issn.2224-5820.2012.01.01

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