Can you comment on best practices for opioid safety in patients at risk for opioid related adverse events with chronic pain
Here are several steps that I would recommend:
- Let overdose education and Naloxone distribution be a helpful way to prioritize safety in discussions with patients and families
- Whenever possible improve non opioid options for pain prior to starting an opioid taper
- Whenever possible taper slowly and arrange for frequent follow-up based upon risk
- Make sure all comorbidities are addressed (medical, mental health and SUD)
- If a slow taper results in deterioration or if there is evidence ahead of time that a taper will result in deterioration assess and treat (when indicated) for OUD/Complex opioid dependence. In patients with chronic pain the medication of choice is usually split dose Buprenorphine/Naloxone.
