Considerations Before Starting Opioid Therapy

Come to Agreement on Problem
Come to agreement with patient on what problem is being treated:  XYZ Pain
Set Treatment Goals
Present Opioids as Test
Present the opioids (or any other treatment for pain) as a trial.  If they don’t help achieve the specified goals, they will be stopped so that other treatments will be tried.  (Note: the entire goal may not be achieved, but the specific treatment should move the patient toward the goals).
Have Patient Sign Informed Consent
Have patient sign informed consent about risks as part of controlled substance agreement
Risks and Benefits
Review Monitoring Practices
Review monitoring practices (urine drug screen, prescription refill policy)
Set Up Next Visit
Set up next visit in 4-6 weeks to assess effect of pain medication.

Additional Resources:

How to Discuss Stopping Opioid Therapy with the Patient CDC Guidelines for Prescribing Opioids for Chronic Pain