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Is the patient in a treatment program for drug or alcohol addiction or under a treatment center/prescriber contract for pain or anxiety management? If yes, dental practitioners optimally should consult with the treatment center or practitioner enforcing the contract to discuss preferred treatment options. Will the medication being administered result in a positive drug screen that potentially could compromise treatment contracts? If yes, dental practitioners and patients should discuss this issue with personnel responsible for the treatment contract before the procedure when possible.

4. 5. 6. 7. 8. 9. 21 tive behaviors will be reinforced with positive rewards. Practitioners of this technique will offer incentives (such as vouchers or gifts) to reward healthy behaviors (such as abstinence and compliance with treatment). 17 Alcoholics Anonymous Perhaps the most widely known program to address alcoholism is Alcoholics Anonymous (AA). AA has been in existence since 1935 and has had faithful participation throughout much of the world. 3). The testimonies of success in AA have engendered similar programs such as Narcotics Anonymous for drug addiction.

30 The ADA Practical Guide to Substance Use Disorders and Safe Prescribing 15. Marlatt GA, Gordon JR. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behavior. 1985. Guilford Press, New York. 16. Petry NM. Contingency management treatments: controversies and challenges. Addiction 2010;105(9):1507–9. 17. Alcoholics Anonymous, 4th ed. 2001. A. World Services. 18. Ries R, Roy-Byrne P, Ward NG, Donnelly P. Carbamazepine treatment for benzodiazepine withdrawal. Am J Psychiatry 1989;146, 536–7.

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