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'.
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.