long term therapy considerations
Long-term opioid therapy should be initiated with treatment goals in mind from the beginning. Realistic goals should be set and based upon a diagnosis. Nonopioid therapy must be optimized. Clear risk benefit needs to be established with the patient prior to initiation of opioid therapy. Every time a prescription is written PMP must be checked. If there are multiple providers here, or there are overlapping narcotic prescriptions this must be discussed with the patient at the time of initiation of therapy. Urine drug screens must be utilized prior to initiation of opioid therapy, and then some metric established for compliance or aberrancy over the course of therapy. Keeping in mind the benefits of long-term opioid therapy are controversial. Understanding risk factors prior to initiation is vital as well. Things such as history of illegal drug use, substance abuse disorder, mental health issues, or concurrent benzodiazepine utilization puts the patient at increased risk. Establishing these parameters from the outset with the patient is crucial in order to frame minimum CDC recommendations when it comes to opioid prescription therapy. Patient's need to be fully completely aware that 1 single provider should be responsible for prescribing their opioids.