Features and overview

Ensure screening and treatment is offered for conditions that can complicate pain management before initiating an opioid taper. Conditions that can complicate pain management are mental health disorders, OUD and other SUD, moral injury, central sensitization, medical complications, sleep disorders. Mental health disorders include PTSD, anxiety disorders, depressive disorders. If suicidal, then activate suicide prevention plan. If high suicide risk or actively suicidal, consult with mental health provider before beginning taper. The lifetime prevalence for OUD among patients receiving long-term opioid therapy is estimated to be about 41%: approximately 28% for mild symptoms, 10% for moderate symptoms and 3.5% for severe symptoms of OUD. Patients with chronic pain who develop OUD from opioid analgesic therapy need to have BOTH pain and OUD addressed. Either tapering the opioid analgesic or continuing to prescribe the opioid without providing OUD treatment may increase the risk of overdose and other adverse events.

Question: What to ensure before initiating an opioid taper?
Answer: screening and treatment is offered for conditions that can complicate pain management

Question: Which conditions can complicate pain management?
Answer: mental health disorders, OUD and other SUD, moral injury, central sensitization, medical complications, sleep disorders

Question: What are some examples of mental health disorders?
Answer: PTSD, anxiety disorders, depressive disorders

Question: What to do if the veteran is suicidal, have high suicide risk or actively suicidal?
Answer: If suicidal, then activate suicide prevention plan. If high suicide risk or actively suicidal, consult with mental health provider before beginning taper.

Question: What to do if the veteran is suicidal?
Answer: activate suicide prevention plan

Question: What to do if suicide risk is high in patients?
Answer: consult with mental health provider before beginning taper

Question: What to do if the veteran is actively suicidal?
Answer: consult with mental health provider before beginning taper

Question: What is the estimated lifetime prevalence for OUD among patients receiving long-term opioid therapy?
Answer: about 41%: approximately 28% for mild symptoms, 10% for moderate symptoms and 3.5% for severe symptoms of OUD

Question: What is the estimation of the lifetime prevalence for mild symptoms of OUD among patients receiving long-term opioid therapy?
Answer: approximately 28%

Question: What is the estimation of the lifetime prevalence for moderate symptoms of OUD among patients receiving long-term opioid therapy?
Answer: 10%

Question: What is the estimation of the lifetime prevalence for severe symptoms of OUD among patients receiving long-term opioid therapy?
Answer: 3.5%

Question: Who needs to have both pain and OUD addressed?
Answer: Patients with chronic pain who develop OUD from opioid analgesic therapy

Question: What needs to be addressed for patients with chronic pain who develop OUD from opioid analgesic therapy?
Answer: BOTH pain and OUD

Question: What may increase the risk of overdose and other adverse events in patients with chronic pain and OUD?
Answer: Either tapering the opioid analgesic or continuing to prescribe the opioid without providing OUD treatment

Question: Tapering the opioid analgesic without providing OUD treatment may increase the risk of what?
Answer: overdose and other adverse events

Question: Continuing to prescribe the opioid without providing OUD treatment may increase the risk of what?
Answer: overdose and other adverse events