Abstract
We are currently in the midst of an epidemic of deaths caused by the misuse of prescription medications. Opioids, benzodiazepines, and stimulants are among the most frequently misused controlled substances and are integral to the neurologist's armamentarium. Thus, the decision to prescribe a controlled substance and how to mitigate the associated risks of their misuse is often vexing to the clinician. This installment in the "Clinical Challenge" series provides a basic narrative overview of the epidemiology of prescription drug misuse, a summary of each of the major classes of misused drugs, and clinical recommendations regarding screening for misuse and reducing the risks associated with prescribing controlled substances.