Guidelines doctors are expected to follow when prescribing opioid analgesics for chronic intractable pain...

From: Helen Dynda (olddad66@runestone.net)
Mon Jan 13 20:59:52 2003


" SPPM ~ Society for Pain Practice Management Note: The use of oral opioids in the treatment of chronic benign pain has been a difficult and controversial issue for physicians who treat pain. Dr. Scott's paper does an excellent job in covering how to safely prescribe oral opioids for these patients."

After you read these guidelines, perhaps you will understand the reluctance of doctors to prescribe opioid analgesics for chronic benign pain.

~ ~ ~ ~

X> Using Oral Opioids for Noncancer Pain: How to Relieve Pain and Protect Your License.

http://www.sppm.org/using_oral_opioids_for_noncancer.htm " On a daily basis, pain practitioners make patient care decisions that affect the lives of our patients. The choice of prescribing oral opioid agents for noncancer pain is one that affects not only your patient, but potentially your own livelihood as well."

General Good Practice Guidelines

1. Documentation of a History and Physical Examination..." Your report should include an assessment of the pain, physical and psychological function, substance abuse history, and assessment of underlying or coexisting diseases or conditions. It should also include the presence of a recognized medical indication for the use of a controlled substance."

2. List your impression, differential diagnosis, and plan..."You are expected to tailor drug therapy to the individual medical needs of each patient. Document that these treatment and outcome goals were discussed with the patient."

3. Document informed consent for opioid use..."You should discuss the specific risks, benefits, and alternatives for the use of opioids with your patient or their guardian."

4. See the patient regularly for follow-up5. Refer for appropriate consultations..."You should periodically review the course of opioid treatment of the patient and any new information about the etiology of the pain."

5. Refer for appropriate consultations..."Refer your patient to the appropriate specialist to help meet the diagnostic and treatment goals outlined in your treatment objectives."

6. Keep complete records..."Document everything discussed. Keep copies of your phone conversations, and of each prescription you write."

7. Know the state and DEA prescribing regulations..."It goes without saying that you should follow the DEA and state rules when writing prescriptions."

8. Follow sound pain management principles..." Use long-acting opioids for chronic pain. Short-acting "breakthrough" opioids should be needed no more than three times a day, if at all."

9. Keep yourself up to date..."A medical board wants to know that you have a sound knowledge base regarding the complications that can occur when prescribing long-term opioids."

THERE IS MUCH MORE TO READ AT THE ABOVE WEBSITE!!


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