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Treatment Guidelines and Risk Assessment

Treatment Guidelines & Risk Assessment

Multiple stakeholders – from government agencies to medical societies – are committed to creating resources for you to help manage your patients with pain. These include treatment guidelines, as well as tools like the ones below, to help assess your patients’ risks for potential abuse or addiction if considering opioids for them.

It is important to remember that opioid therapy in general should only be used when alternative treatment options are inadequate. In addition to carrying a significant risk for misuse, abuse and addiction, opioids also can produce serious side effects. It is important to assess the risks versus benefits for each individual opioid and for each specific patient.

Guidelines on the Management of Post-Operative Pain

Recommendations developed by a multidisciplinary expert panel including the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine and the American Society of Anesthesiologists that stress safe and effective postoperative pain management should be on the basis of a care plan tailored to the individual and surgical procedure involved.

Interagency Guideline on Prescribing Opioids for Pain

Developed by the Washington State Agency Medical Directors’ Groups (AMDG) in collaboration with a broad advisory group. Offers a balanced approach to pain management that includes recommendations for using opioids when appropriate, such as with acute injuries and flare-ups, for postoperative pain management and during painful procedures, and recommending multimodal therapies in general for all chronic pain patients.

Clinical Practice Guideline for Opioid Therapy for Chronic Pain

The Veterans Health Administration and Department of Defense chronic pain guideline is intended to provide a framework by which to evaluate, treat and manage the individual needs and preferences of patients with chronic pain who are on or being considered for long-term opioid therapy (LOT).

Guidelines for the Chronic Use of Opioid Analgesics

This policy document by the Federation of State Medical Boards is intended as a resource providing overall guidance to state medical and osteopathic boards in assessing physicians’ management of pain in their patients and whether opioid analgesics are used in a medically appropriate manner.

Diagnosis and Treatment of Low Back Pain

A joint clinical practice guideline from the American College of Physicians and the American Pain Society that provides guidance on issues including determining when to initiate or continue opioids, opioid selection, dosage, duration, follow-up and discontinuation, and assessing risk and harms of opioid use.

CDC 2016 Guideline for Prescribing Opioids for Chronic Pain

Provides guidance for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care and end-of-life care. It discusses issues including determining when to initiate or continue opioids, opioid selection, dosage, duration, follow-up and discontinuation, and assessing risk and harms of opioid use.

Checklist for Prescribing Opioids for Chronic Pain from CDC

Offers considerations to keep in mind, as well as references for evaluating risk of harm or misuse and non-opioid therapies.

NIDA Drug Screening Tool

Screening tool that guides healthcare professionals through a series of questions to identify risky substance use in adult patients.

Opioid Risk Tool (ORT)

Self-report screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain.

VA Guide: Opioid Taper Decision Tool

Guide that helps healthcare professionals taper off opioid medicines for chronic pain.

AAPM: Essential Tools for Treating the Patient in Pain

CME course designed for clinicians interested in the fundamentals of pain medicine and practical approaches to the treatment of common pain disorders.

NIDA: Opioid & Pain Management

CME courses that provide guidance for healthcare professionals in screening pain patients for substance use disorder risk factors before prescribing, and in identifying when patients are abusing their medications.

REMS: Opioid Analgesic Education

Search portal that helps healthcare professionals find CME courses for opioids.