Opioid Risk Management: Tools and Tips

by Howard S. Smith, Perry G. Fine

Overview

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 opioid prescribing, 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 contains updated guidelines on opioid selection as well as legal and regulatory resources.

Product Details

ISBN-13:	9780199862054
Publisher:	Oxford University Press
Publication date:	11/21/2013
Series:	Oxford American Pocket Notes
Edition description:	2nd Revised ed.
Pages:	64
Product dimensions:	6.90(w) x 5.70(h) x 1.20(d)

About the Author

HSS: Professor of Anesthesiology and Director of Pain Management, Department of Anesthesiology, Albany Medical College, Albany, New York. PGF: Professor of Anesthesthesiology, University of Utah Health Sciences Center, Salt Lake City, Utah.

Table of Contents

1. Introduction
2. The Four A's: 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