Drugs of concern

Drugs of Concern
There are a whole range of drugs of concern that one can become dependent upon or become addicted to and this list can seem daunting. The list of drugs that a 'use disorder' can be appended to under the DSM 5 criteria is similarly long. Dr Ferghal Armstrong though provides us with a useful mnemonic to remember these drugs 'COCA SHITS'.
• Cocaine
• Opioids
• Cannabis
• Alcohol
• Stimulants
• Hallucinogens
• Inhalants
• Tobacco
• Sedatives
Similarly an alternative classification system of drugs of dependence making it easier to remember these drugs is as follows:
The Legals
Alcohol tobacco
The prescribed
Opiates benzodiazepines quetiapine pregabalin stimulants
The uppers
Cocaine amphetamine methamphetamine
Downers
Heroin cannabis
Party drugs
MDMA LSD magic mushrooms GHB
Identifying those patients who may be ta risk of prescription drug aberrancy can be difficult and is an area that can leave a doctor feeling quite fraught. A useful set or patterns of behaviours to be aware of can be remembered through Dr Armstrong's mnemonic 'USE TALK'
Urgency
Unscheduled medical appointments
Splitting
"You are the only one who can help"
Efficacy
"Nothing else works for me"
Timing
Saturday afternoon and I have run out of my medication – no option for cross checking with other agencies
Allergies
"I am intolerant of all other pharmacological options"
Lost
Lost prescriptions that trigger requests for further replacement prescriptions
Knowledge
High degree of knowledgeability surrounding the drug in question
Author: Dr Thileepan Naren
MBBS FACRRM FRACGP
Thileepan is an Addiction Medicine Advanced Trainee and experienced general practitioner with a demonstrated history of working with disadvantaged and marginalized groups.