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  • The Opioid Prescribers Group

  • The Opioid Prescribers Group was founded two years ago to address the alarming rise in drug overdose deaths in Southern Oregon and to provide a standard of care for treating chronic pain.
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  • The Opioid Prescribers Group was founded two years ago to address the alarming rise in drug overdose deaths in Southern Oregon and to provide a standard of care for treating chronic pain.
    Some of its recommendations:
    Assessment
    • Review patient's medical history, including records from previous providers.
    • Administer a physical exam to determine baseline function and pain.
    • Determine whether prior attempts were made to address the pain with non-narcotic treatments.
    • Be sure the diagnosis is appropriate for opioid treatment.
    • Do a psychosocial and risk assessment to determine risk of medication abuse and psychiatric co-morbidity.
    Nonopioid options
    • Create a plan of treatment that incorporates interventions without the use of opiate medication.
    • Help patients improve their lifestyle with exercise and weight loss.
    • Incorporate therapies such as support/education groups, case management, psychotherapy, physical therapy and occupational therapy.
    • Determine which medical interventions are appropriate, such as pharmacological, procedural, surgical.
    Opioid treatment
    • Proceed with caution.
    • Perform a urine drug test prior to prescribing.
    • Check for evidence of possible misuse.
    • Require patient to sign a treatment agreement.
    • Agree on and document treatment goals.
    • At every visit, assess for changes in function and pain, evaluate progress on treatment goals, assess for aberrant behaviors and assess for adverse side effects.
    Reassessment
    • If no improvement or if aberrant behavior or adverse side effects are observed, stop and reassess the treatment.
    • Re-evaluate your treatment plan and seek help from specialists if you are: Prescribing more than 120 mg of morphine-equivalent doses without obvious functional improvement; prescribing opioids with benzodiazepines; prescribing more than 40 mg of methadone a day.
    The guidelines can be found at www.SouthernOregonOpioidManagement.org.
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