Module B (sect 2):  Initiation of Treatment with Opioids
​CONTINUED...
Reevaluation as needed clinically and based on patient risk factors (e.g., 1-4 weeks after initiation of opioids, not later than 30 days:
  • ​ASSESS:
    • ​Function, risks, and benefits of opioids
    • Adverse effects
    • ​Adherence to treatment plan
    • ​Complications or co-occurring conditions (e.g., medical, behavioral health, and/or substance use disorder)
    • Patient preference
  • Complete risk mitigation strategies (see Sidebar E)
  • Review and optimize comprehensive pain care plan (e.g., non-opioid treatments, self-management strategies)​ ​​
Does the patient want to continue opioid therapy?
  • Taper to discontinuation and consult Module C if needed.
  • Manage with non-opioid modalities.
Does the patient want to continue opioid therapy? - continued
Is there clinically meaningful improvement in function and pain that outweighs risks?
  • Taper to discontinuation and consult Module C if needed
  • Manage with non-opioid modalities
Is there clinically meaningful improvement in function and pain that outweighs risks? - continued
Is the patient sufficiently medically and behaviorally stable to continue opioid medication?
  • Provide medical and/or behavioral health treatment to stabilize as indicated
  • Consider tapering opioids to discontinuation (consult Module C)
Is the patient sufficiently medically and behaviorally stable to continue opioid medication? - continued