Develop an individualized treatment plan (including pace of tapering if applicable and setting of care) based on patient and treatment characteristics (see Sidebar J and Recommendations 12 & 13)
Recommendations 12 & 13
- Follow-up as clinically indicated after each change in dosage and after discontinuation, considering patient and treatment characteristics
- Consider the following at each interaction with patient:
- Educate on self-management and risks of opioids (see Sidebar K)
- Optimize whole person approach to pain care
- Reassess for OUD and readiness for OUD treatment as indicated
- If continuing treatment with opioids, use the following approach:
- Shortest duration
- Use lowest effective dose (recognizing that no dose is completely safe and overdose risk increases at doses >20-50 mg MEDD (see Sidebar L)
- Continual assessment of improvement in pain and functional status and adverse effects.
Are one of the following present?
- Patient resistance to taper
- High risk or dangerous behaviors (including elevated risk of suicide)
- Increase in patient distress
Are one of the following present? - continued
- Patient resistance to taper
- High risk or dangerous behaviors (including elevated risk of suicide)
- Increase in patient distress
