Manchikanti et al classified patients with chronic pain who misused prescription drugs. The authors are from the Pain Management Center of Paducah, Kentucky.
Parameters:
(1) number of physician prescribing a controlled drug
(2) schedule of controlled drug being used
(3) abuse
(4) serious problems
Level of Abuse
Grade
none
0
low
I
moderate
II
significant, serious
III
Number of Doctors Prescibing
Schedule
Abuse
Grade
1 or 2
SIII or SIV, no SII
I
3 or more
SIII or SIV, no SII
IIA
NA
receiving SII
anything but except SII
IIB
NA
receiving SII
abusing SII
IIC
Serious problems:
(1) trafficking (IIIA)
(2) overdose (IIIB)
Limitations:
• Others forms of abuse (alcohol, etc) not included in Grade.
• Trafficking can probably be subdivided.
• The overdose category could probably be expanded into any serious health complication as a result of the prescription drug abuse.
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