Making a Plan to Treat Pain with Opioids

Creating your treatment plan

Before prescribing opioids for your pain, your healthcare provider will work with you to make a treatment plan. This will help make sure you get the safest treatment for your pain that works well. Your treatment plan will start with talking about:

• Your pain levels

• Your health history

• Your treatment goals

If your healthcare provider prescribes opioids, will then make a plan with you for:

• How long to use the medicines

• When to stop them

• How to stop them safely

You’ll also need regular follow-up care while you’re taking the medicine.

Shared decision-making

Shared decision-making means that you and your healthcare team work together to make decisions about your care. It's important to know all of your options. This will help you choose the care and treatment that's right for you. When considering opioid medicines, make sure to:

• Tell your healthcare provider if you have a history of substance use with drugs or alcohol.

• Talk about ways to help manage your pain that don’t involve opioids.

• Understand the benefits, risks, and side effects of opioid treatment.

• Ask questions and discuss your concerns before and during your opioid treatment.

Your health and pain history

Before prescribing opioid medicines, your healthcare provider will assess your pain and overall health. They will:

• Give you a physical exam

• Review your pain history and health history

• Ask about your mental and emotional health

• Ask if you have a personal or family history of substance abuse, such as drugs and alcohol

Be open and honest with your healthcare provider. This will help ensure that a safe plan is made for you. 

Your healthcare provider will ask you questions about your pain. They may ask you:

• To describe how your pain affects your life. This can include how it affects your relationships, work, and sleep.

• How long you've been having pain, how severe it is, and if it's getting better or worse

• What you've done to treat your pain and what did and didn’t help. This includes any alternative healing practices you've tried.

• What medicines you take or have taken for pain. This includes all prescription and over-the-counter medicines, herbal remedies, supplements, and illegal drugs.

• To keep a diary to track your pain before starting any opioid medicines

Tests and screenings

Before opioid treatment, you may need tests and screenings. Some of these may need to be repeated during the course of your treatment. This depends on your risk for side effects. Tests and screenings may include:

• Urine or blood tests to screen for drugs

• Blood tests, including kidney and liver function tests

• Chest X-ray

• Electrocardiogram (ECG)

• Testing for hepatitis C, HIV, and tuberculosis (TB)

Setting treatment goals

You and your healthcare provider will talk about reasonable goals for your pain. Opioid medicines can help reduce your pain. But they often can't provide full relief. When you have pain, the main goal of treatment is to relieve pain to a level that is OK for you. This should help to improve your function in daily life. Your daily function can improve even when you still have some pain.

The benefits of long-term use of opioids for pain are unclear. It’s best to only use opioids if they continue to help pain and function without raising risks to your health.

Regular follow-up visits

You’ll need to see your healthcare provider for regular follow-up visits if you take opioids. It's very important to keep these visits as scheduled. They help you and your healthcare provider track how well treatment meets your goals. They help track and manage side effects. This helps ensure the medicines work well for you and are still safe for you.

Stopping opioid medicine safely

To stop opioid medicine safely, you will need help from your healthcare provider. This will help to manage your withdrawal symptoms. You and your healthcare provider will discuss a plan for when and how to stop opioid treatment. In most cases, the amount of medicine you take will be cut down. You will be weaned off the medicine slowly.