Health care providers often request guidance on how to have conversations with patients about opioids, pain treatment, addiction and other topics that may be challenging. In this collection, we have gathered materials that provide support to providers as they have these difficult conversations.
A toolkit prepared by the Veterans Health Administration to help primary care providers manage opioid tapering in their practices. It includes steps to take before beginning a taper including assessing the patient for conditions that might complicate the tapering process and communicating directly with the patient about opioid safety and tapering options.
A systematic review of the evidence for long term outcomes of tapering opioid doses in patients on long term opioid therapy for chronic pain from the Veterans Affairs Evidence Synthesis Program (ESP). The report analyzes published studies to determine the benefits and harms for patients when tapering their opioid medications to lower doses or discontinuation and reviews whether benefits and harms vary by
Guidance for clinicians on how to taper patients’ long-term opioid prescriptions to lower dosages or discontinuation from the U.S. Department of Health and Human Services.
This 2016 toolkit from Partnership Health Plan of California provides guidance for providers seeking to engage their patients in a step-wise, physician directed tapering of their opioid dose. The toolkit has 4 sections: how to identify candidates for tapering, how to collaboratively set a tapering plan with the patient, how to manage the tapering process and complications, and advice on planning for special situations
This 2015 video from Dr. Andrea Rubinstein provides guidance to providers on how to work with patients to taper their opioid medication dosage. Includes a discussion on indications for tapering, 10 best practices for
The 2017 Nebraska Pain Management Guidance document was developed by an expert advisory task force consisting of actively practicing clinicians and prescribers, public health officers and senior state officials. The guidance is notable for addressing a broad range of topics including
The supplementary materials to support the systematic review of the evidence for long term outcomes of tapering opioid doses in patients on long term opioid therapy for chronic pain from the Veterans Affairs Evidence Synthesis Program (ESP). These materials include search strategies used in the systematic review, inclusion/exclusion criteria for studies reviewed, evidence tables, and quality assessment of studies included in the review.
In 2018 the Arizona Legislature passed the Arizona Opioid Epidemic Act. This one page information sheet for patients explains how the legislation protects chronic pain patients who use opioids to treat their pain. The document clarifies that the act does not limit prescription fills for chronic
This website includes all of the pain treatment guidelines prepared by the Oregon Pain Guidance commission including guidelines on acute pain, chronic pain, low back pain, alternatives to pharmacological treatment of pain, treating pain in children and senior citizens, pain control for cancer and palliative care, opioid