By switaschek, 27 April, 2016 Use nonpharmacologic tx/non-opioid pain meds if possible. If opioids used: urine test 1st, combine w/ non-opioid/nonpharmacologic tx, mitigate risks, re-eval in 1-4 wks
By switaschek, 27 April, 2016 Use lowest effective dose of immediate-release opioids;2 never use ER/LA opioids in opioid-naive pts [A/4]. Combine w/ nonpharmacologic + non-opioid tx [A/3]
By switaschek, 27 April, 2016 Prior to opioid tx: Assess baseline pain + fxn,1 set realistic goals and criteria for stopping if risks exceed benefits [A/4]. Obtain urine drug screen for opioids, undisclosed Rx drugs, illicit drugs [B/4]
By switaschek, 27 April, 2016 Opt for nonpharmacologic tx (eg, exercise, weight loss, CBT, intra-articular steroids) or non-opioid pain meds (eg, NSAIDs, TCAs, SNRIs, anticonvulsants). [A/3] Consider opioids only if expected benefits for both pain + fxn anticipated to outweigh risks [
By switaschek, 27 April, 2016 Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. <i>MMWR Recomm Rep</i> 2016; 65:1–49.