CDC Recommendations

Opioid medication should be initiated as a short-term trial to assess the effects of opioid treatment on pain intensity, function, and quality of life.

The prescriber should clearly explain to the patient that initiation of opioid treatment is not a commitment to long-term opioid treatment and that treatment will be stopped if the trial is determined to be unsuccessful. The trial should be for a specific time period with pre-determined evaluation points as defined in the treatment plan measures. The decision to continue opioid medication treatment beyond the trial period should be based on the balance between benefits gained in function and quality of life, and adverse effects experienced. Criteria for cessation should be determined before treatment begins.

When a new patient has already been receiving opioid therapy for a chronic condition, the same recommendations apply: assess the patient’s chronic pain, complete a comprehensive evaluation, screen for risk of substance use disorder, establish a treatment plan and informed consent, initiate treatment trial, mitigate risks, and consider a multi-disciplinary approach. The evaluation process may require more time than the initial appointment, so the prescriber must use their professional judgment if opioids are deemed necessary. If opioid treatment is necessary, it is suggested that the dose be limited and only long enough to complete an adequate evaluation and to seek consultation, as needed.