Patient Agreement For Opioid Use
Review this example of an opioid doctor-patient agreement from Washington State Department of Labor and Industries
Translating Morphine Equivalents
Morphine Equivalents above 50/ day carries an increased risk of overdose and the provider may consider other measures of treatment and/or taper if above 90 meq per day. Morphine Equivalent Dose (MED) Calendar
Tools for Risk Assessment and Mental Health Screening
For patients with chronic opioid usage, a psychological evaluation must be performed (per the Medical Treatment Guidelines).
- Opioid Risk Tool
- CAGE Substance Abuse Screening Tool
- Screener and Opioid Assessment for Patients with Pain
- Current Opioid Misuse Measure (COMM)
- DIRE Patient Selection for Chronic Opioid Analgesia
For patients with acute opioid usage, psychological screens may be used from the Colorado Division of Workers’ Compensation Quality Performance Outcomes Payments (QPOP) Program.
Functional assessments should include open ended questions to assess the patient’s work activities, leisure activities and activities of daily living. The Colorado Division of Workers’ Compensation Quality Performance Outcomes Payments (QPOP) Program Functional Tools are useful.
Colorado Physician Drug Monitoring Program (PDMP)
Any patient with the continued use of opioids should be monitored.
Drug Testing is required when a patient starts a trial of opioids. The following Interagency Guideline on Prescribing Opioids for Pain, developed by the Washington State Agency Medical Directors’ Group (AMDG) is useful information regarding drug testing:
- Using Urine Drug Testing (UDT) to Monitor Opioid Therapy for Chronic Non-cancer Pain (p. 63)
- UDT Algorithm for Monitoring Opioid Therapy (p. 67)
- UDT Clinical Vignettes in Chronic Non-cancer Pain (p. 68)
- UDT Frequently Asked Questions (FAQ) (p. 70)
- American Psychiatric Association’s DSM 5 Criteria for Substance Use Disorder
- Motivational Interviewing in Health Care
- American Association of Chronic Pain Opioid information
- Substance Abuse and Mental Health Services Administration: Opioid Prescribing Courses for Health Care Providers
- Colorado Division of Regulatory Agencies: Information for healthcare providers to treat pain and combat prescription drug abuse
- Medical Society of the State of New York: Pain Management, Palliative Care and Addiction 3 hour Webinar