Links to two sample chronic pain contracts that address the use of the emergency department and the agreement with the primary care physician.
Your Pain Treatment Agreement.
Documents the understanding between the patient and the prescriber. An example of a pain treatment agreement is provided.
Initiating Opioid Treatment in the Emergency Department (ED) Frequently Asked Questions (FAQs):
Medication-assisted treatment (MAT) with buprenorphine is one strategy emergency physicians can use to address the opioid epidemic.
Safe Opioid Prescribing PCSS-O: iPhone App:
Evidence-based resources that are currently available to clinicians on the safe and effective use of these medications. Offers multiple resources related to opioid prescribing and the diagnosis and management of opioid use disorders including treatment agreements, tools to assess pain level, and links to guidelines. Sponsored by the American Academy of Addiction Psychiatry with support from SAMHSA.
Community-based public health program based on the premise that drug overdose deaths are preventable. The program, based on prevention and opioid safety, was developed and implemented in North Carolina, an area with a higher than average overdose death rate. The program includes resources for overdose survivors, patients, medical personnel, and legal considerations.
Chronic Opioid Treatment
Managing Chronic Pain in Adults With or in Recovery from Substance Use Disorders: A Treatment Improvement Protocol
SAMHSA Tip 54. Addresses assessment, treatment plan development, functional impairment, and psychological symptoms and monitoring for relapse.
Multifaceted Program Featuring Guideline, Training, and Incentives Reduces Prescribing of High-Dose Opioid Therapy in Patients with Chronic Pain.
AHRQ Health Care Innovations Exchange. State guidelines were used as a framework for this work.
Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain.
J Pain. 2009;10(2):113-130.
What do we know about opioid-induced hyperalgesia?
Reviews the literature on opioid-induced hyperalgesia (OIH), a condition caused by exposure to opioids to treat pain, resulting in the patient becoming more sensitive to painful stimuli. OIH and opioid tolerance can reduce treatment efficacy. The article concludes that while the OIH phenomenon has been documented for over two decades, the clinical characteristics and mechanisms are not fully determined.
Safe and Effective Opioid Prescribing for Chronic Pain.
Sponsored by the Boston University School of Medicine with support from SAMHSA, this site presents course modules on prescribing opioids for chronic pain. CME credits available.
National Survey of Substance Abuse Treatment Services.
This SAMHSA publication presents 2011 survey data on public and private treatment facilities in all 50 states, including location, client, and facility characteristics.