Module 3: Assessment

Lesson 3

Safety considerations

While controlled substances are not the standard of care for the treatment of insomnia, patients may present to your practice who have been prescribed controlled substances, such as benzodiazepines for insomnia (Schutte-Rodin et al., 2008).

Screening for the following is, therefore, recommended:

• Substance use history
• Current, past, and family history of substance misuse, abuse, and addiction must be assessed (alcohol, marijuana, tobacco, prescription medications, cocaine, non-prescription stimulants and other agents, hallucinogens, and solvents).
• Any attendance at a treatment program for addiction (See Appendix B-1 for tools and interview guides to assist in taking a substance use history)
• Assessment of factors that may indicate a higher risk for medication misuse:
  • History of alcohol or substance abuse (patient and/or family)
  • Uncertain security in the home (e.g., living in a boarding home with minimal protection for  possessions)
  • Past aberrant drug-related behaviours
  • Urine drug screening for baseline data and for monitoring