Responsible opioid prescribing

If indicated and a trial of therapy is considered, opioids should only be used in conjunction with a multimodal treatment plan with clear functional goals, regular reassessment and include a taper and cease strategy. 1-3

  • Continue non-opioid therapy

    Continue non‑opioid therapy

    Non-opioid analgesia should be optimised and non‑pharmacological interventions continued.

  • Agreement and communication with patient

    Agreement and communication with patient

    Discuss the risks of opioids, set realistic functional goals and agree on prescribing terms.

  • Regular assessment of harms and benefits

    Regular assessment of harms and benefits

    Set regular appointments to assess the 5As (analgesia, activity, adverse effects, affect, aberrant behaviour - addiction is possible even when opioids are taken as directed), dosage and whether referral to a Specialist is required.

  • Exit plan

    Exit plan

    Discuss expectations of treatment duration and plan regular attempts to taper dose/cease opioid treatment.

REFERENCES: 1. Faculty of Pain Medicine, ANZCA. PS01(PM) Statement regarding the use of opioid analgesics in patients with chronic non-cancer pain [Internet]. 2020. Available at https://www.anzca.edu.au/safety-advocacy/standards-of-practice/policies,-statements,-and-guidelines [cited 6 July 2020]. 2. The Royal Australian College of General Practitioners. Prescribing drugs of dependence in general practice, Part C2: The role of opioids in pain management. East Melbourne, Vic: RACGP, 2017. 3. Schug SA et al; APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine (2015), Acute Pain Management: Scientific Evidence (4th edition), ANZCA & FPM, Melbourne.