When thinking abut the epidemic of substance abuse, it is is important to understand that physicians are both a part of the problem and additionally a part of the solution. The improper use of pain medications, particularly escalating pain meds in a non step ladder fashion contributed to the addiction that has finally come to light now. I agree with the latest legislative changes limiting our prescription of opiod narcotics without serious indications and precautions follow up. Hence i believe it is mandatory to ask all patients during every visit after establishing rapport and asking in a friendly non judgmental way if our patients are using illicit drug or prescription drugs inappropriately. Listening with empathy most definitely will reveal any underlying disorder in most instances as this emotional trait has the ability to allow people to openly expose hidden dilemmas. Only then will we be able to be a part of the solution. If we are not vigilant of the repercussions of limiting prescription opiods,we could encounter an even bigger problem of patients seeking street drugs instead. Hence, directing patients to support groups is important during this transitional period.
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