Caring For Patients With Chronic Pain
Responsible Opioid Prescribing to Achieve Individualized Functional Goals
Meeting Slides
Clinical Tools
Brief Pain Inventory (Short Form)
A multidimensional pain assessment instrument that can be used to characterize several aspects of a patient’s pain experience, the short form is also widely used for clinical trials and has been translated into multiple languages.
Opioid Risk Tool
This five-question clinical interview or patient questionnaire helps stratify patients based on their risk for opioid-related misuse and abuse.
Current Opioid Misuse Measure (COMM)®
A 17-item assessment questionnaire, the COMM focuses on current behaviors and cognition rather than character and personality traits associated with risks for substance abuse.
Pain Assessment and Documentation Tool (PADT™)
Completed via clinician-directed interview, this instrument provides a consistent and structured method to document progress with opioid therapy over time.
Guidelines
American Pain Society and American Academy of Pain Medicine: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain
Chou R, Fanciullo GJ, Fine PG, et al. J Pain. 2009;10(2):113-130.
Department of Veterans Affairs and Department of Defense: Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain
The Management of Opioid Therapy for Chronic Pain Working Group. Washington, DC: Department of Veterans Affairs, Department of Defense; 2010.
Other Resources
A Clinical Guide to Opioid Analgesia. 2nd edition
Fine PG, Portenoy RK. New York, NY: Vendome Group, LLC; 2007.
Responsible Opioid Prescribing: A Clinician’s Guide. 2nd edition, revised and expanded
Fishman SM. Washington, DC: Waterford Life Sciences; 2012.
Suggested Readings
Abuse rates and routes of administration of reformulated extended-release oxycodone: initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment
Butler SF, Cassidy TA, Chilcoat H, et al. J Pain. 2013;14(4):351-358.
Establishing "best practices" for opioid rotation: conclusions of an expert panel
Fine PG, Portenoy RK; Ad Hoc Expert Panel on Evidence Review and Guidelines for Opioid Rotation. J Pain Symptom Manage. 2009;38(3):418-425.
Universal precautions in pain medicine: a rational approach to the treatment of chronic pain
Gourlay DL, Heit HA, Almahrezi A. Pain Med. 2005;6(2):107-112.
Urine drug testing in pain medicine
Heit HA, Gourlay DL. J Pain Symptom Manage. 2004;27(3):260-267.
Substance misuse treatment for high-risk chronic pain patients on opioid therapy: a randomized trial
Jamison RN, Ross EL, Michna E, et al. Pain. 2010;150(3):390-400.
Assessment and treatment of abuse risk in opioid prescribing for chronic pain
Jamison RN, Serraillier J, Michna E. Pain Res Treat. 2011;2011:941808.
A review of abuse-deterrent opioids for chronic nonmalignant pain
Moorman-Li R, Motycka CA, Inge LD, et al. P T. 2012;37(7):412-418.
Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics
Schaeffer T. J Med Toxicol. 2012;8(4):400-407.
Interactive PresentationLong-term Opioid Therapy for Chronic Pain
Michael J. Brennan, MD
Responsible Opioid Prescribing to Achieve Individualized Functional Goals
Relevant Resources
Balancing the Benefits and Risk of Opioid-Based Therapy
Individualized Assessment and Mechanism-Based Multimodal Treatment
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Proactive Diagnosis and Targeted Management
Selecting Patients and Optimizing Long-Term Outcomes
Proactive Diagnosis and Targeted Management
Consensus and Controversies for Responsible Opioid Prescribing
The Role of Nurses in Optimizing Long-term Outcomes
Evolving Best-Practice Strategies to Maximize Efficacy and Safety
A Focus on Patients With Opioid-Induced Constipation
Patient Selection, Treatment Initiation, and Ongoing Monitoring
Engaging With Patients About Opioid-Induced Constipation
The PCP’s Role in Timely Recognition and Referral
Debates and Discussions About Therapeutically Targeting Nerve Growth Factor Signaling
Expanding the Conversation on Opioid-Induced Constipation
Let’s Talk Constipation
