Prescription drug abuse. A question of balance.

The current American medical practice paradox of concomitant overprescribing and underprescribing of controlled drugs is within the power of physicians to correct. It requires actively seeking education in traditionally neglected areas and avoiding prescribing controlled drugs to patients with either substance abuse histories or vague clinical indications. Attempts to limit prescribing to short therapeutic time courses, refusal to prescribe if pushed, and careful chart documentation practices are important. By increasing knowledge about chemical dependence and about chemically dependent patients' abnormal relationships with scheduled drugs, the current clinical reality can be reversed. This reversal will result in marked decreases in prescribing to the minority of patients (those with chemical dependence) and increases in prescribing to the majority of patients who are currently often undertreated.