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.

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.