Chronic pain is one of the most common and debilitating health care conditions, and among the most notoriously challenging to treat. Chronic non-cancer pain presents a significant burden to society in terms of lost workforce productivity and significant healthcare resource utilization and cost. Although controversies persist surrounding the use of opioid analgesics, consensus now exists among medical experts that they can be useful for carefully selected patients. Safe opioidprescribing, however, hinges on effective risk management. All clinicians who treat pain with opioids are obliged to implement therapy according to accepted principles of prescribing and to minimize the risk of misuse, abuse, addiction, and diversion through risk assessment and management strategies.Proper risk assessment allows for a care plan that is structured to optimize therapeutic outcomes while minimizing risks of potential opioid-related morbidities or problematic drug-related behaviors as effectively as possible. Opioid Management Tools and Tips provides health professionals with basic guidance, tools, and resources for identifying patients who may be at risk for opioid misuse and effective managing the risk of abuse, addiction, and diversion. This second edition containsupdated guidelines on opioid selection as well as legal and regulatory resources.
1. Introduction; 2. The Four As: Domains for Pain Management Outcomes; 3. Principles of Responsible Opioid Prescribing; 4. Documentation; 5. Defining Addiction, Physical Dependence, Tolerance, and Diversion; 6. Prior to Initiating Chronic Opioid Therapy; 7. Selection of Opioid Analgesic; 8. Tools to Guide Decision Making, Stratify Risk, and Structure Therapy; 9. Opioid-specific Screening Tools; 10. Revised Screener and Opioid Assessment for Patients with Pain; 11. D.I.R.E Score; 12. Managing the Risk of Abuse, Addiction, and Diversion; 13. Urine Drug Testing; 14. Assessing Outcomes of Opioid Therapy; 15. Documentation Tools in Long-Term Opioid Therapy; 16. Managing Aberrant Drug-related Behavior; 17. Quick Scan of Selected Opioid Pharmacokinetic Data; 18. Legal/Regulatory Materials and Resources on the Use of Controlled Substances to Treat Pain; 19. Recommended Reading to Increase Skills, Knowledge and to Guide Practice; 20. Internet Resources to Increase Skills and Knowledge, and to Guide Practice; 21. References;
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