Provider Toolkits
Recommendations
The Centers for Disease Control and Prevention (CDC), in determining when to initiate or continue opioids for chronic pain (pain lasting longer than 3 months or past the time of normal tissue healing), recommend the following:
- Non-pharmacologic therapy and non-opioid pharmacologic therapy are preferred first line treatments for chronic pain, with opioid therapy being considered only after a risk benefit analysis shows that expected benefits for both pain and function are anticipated to outweigh risks to the patient. If used, opioids should be combined with non-pharmacologic therapy and non-opioid pharmacologic therapy, as appropriate.
- Before starting opioid therapy, clinicians should establish treatment goals with all patients, including realistic goals for pain and function. Discontinuing opioid therapy if benefits do not outweigh risks should also be considered. Clinicians should continue opioid therapy only if there is clinically meaningful improvement in pain and function that outweighs risks to patient safety.
- Before starting and periodically during opioid therapy, clinicians should discuss with patients the known risks and realistic benefits of opioid therapy, and patient and clinician responsibilities for managing therapy.
Additional Resources
- Provider’s Clinical Support System for Opioid Therapies (PCSS-O)* – Additional guidance on the safe and effective use of opioids for the treatment of chronic pain
PCSS-O is a national training and mentoring project developed in response to the prescription opioid overdose epidemic.
*Funding for this initiative was made possible (in part) by Providers' Clinical Support System for Opioid Therapies from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Toolkits
The Primary Care Provider (PCP) Pain Management Toolkit provides information on recommended non-opioid and opioid treatments and services for chronic pain.
The Emergency Department Practitioner Pain Management Toolkit provides information on opioid risk assessments, medication assisted treatment, and non-opioid services and treatments for chronic pain.
The Tapering Toolkit provides guidelines for identifying patients for tapering, engaging the patient, assessing readiness to change, and developing a tapering plan.
The SAMHSA Opioid Overdose Prevention Toolkit offers strategies to healthcare providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths.
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