Opioid Prescribing Toolkit

Relief of pain is one of the most ancient and important obligations of the physician. Relieving both acute and chronic pain frequently requires the use of opioid analgesics. Like all medications, opioids are associated with complications, including the risk of abuse and addiction. This toolkit aims to mitigate some of the anxiety surrounding opioid prescription by providing the essential information necessary to help busy clinicians make informed decisions for their patients about effective and responsible pain management.

The risks and benefits of opioid therapy depend upon the patient, prescriber, practice setting, and community. Opioids have been shown to work for most kinds of pain, and most opioids have similar efficacy. However, like all other analgesics for chronic pain, opioids only work for a minority of patients long-term, and even then only partially relieve pain. To ensure responsible patient care, physicians must have realistic expectations concerning the efficacy of long-term opioid therapy, and must impart these expecations to patients and their families.

It is an unwavering obligation of all physicians to treat pain aggressively, just like it is important to treat diabetes, asthma, or any other illness aggressively. However, there are many approaches to pain management, and no obligation exists to provide opioids when the risks outweigh the benefits, or when a reasonable trial of opioid therapy has not produced a favorable risk-benefit balance. This toolkit provides essential information and guidance to aid time-pressed clinicians in making rational medical decisions regarding effective and responsible pain management.

This practical workbook provides a comprehensive array of user-friendly tools to help physicians safely and effectively prescribe opioids to patients with chronic pain. In addition to clear algorithms, report templates, and even instructions for busy office staff, this concise volume provides invaluable "how to" guidance for easy adoption in the clinical setting, including how to assess opioid prescription usage and implement triage, rotation, and exit strategy. Authored by a renowned expert in the field of pain medicine and risk management, this concise yet comprehensive workbook is an invaluable resource for all clinicians treating patients with significant pain, including primary care practitioners, oncologists, and rheumatologists, as well as medical residents in pain medicine, palliative medicine, and anesthesia.

Nathaniel P. Katz, MD, MS, is President of Analgesic Solutions in Natick, MA, as well as Adjunct Assistant Professor of Anesthesia at Tufts University School of Medicine in Boston, MA.