#4 Opioid prescribing in chronic pain

Today we will cover opioid prescribing guidelines for chronic non-cancer non-palliative care pain in adults.  Enjoy!   Contents: •New codeine laws 2018 •Opioids prescription facts and harms •Evidence for opioids •Types of opioids and equivalence dosing •Side effects – short and long term •Initiating and ongoing presciprtion •Break through pain management •Discontinuing •Aberrant behaviour management and assessment •Follow up consideration •Not  - opioid replacement therapy like methadone and suboxone   References: •Qld health - https://www.health.qld.gov.au/__data/assets/pdf_file/0032/374693/ddu_quick_guide.pdf - great 4 pager •CDC guidelines - https://www.cdc.gov/drugoverdose/prescribing/guideline.html •http://jamanetwork.com/journals/jama/fullarticle/2503508 •SA health - http://www.sahealth.sa.gov.au/wps/wcm/connect/7b1378004ddce5e2965efe6d722e1562/Opioid_prescription_chronic_pain_guidelines_for_SA_GPs_ALL.PDF?MOD=AJPERES&CACHEID=7b1378004ddce5e2965efe6d722e1562 •Hunter integrated pain service NSW guidelines – great 2 pager https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0018/212760/Opioid_treatment_agreement.pdf •Hunter Integrated Pain Service http://www.hnehealth.nsw.gov.au/Pain/Documents/Reconsidering_opioid_therapy_May%202014.pdf •http://www.emrpcc.org.au/wp-content/uploads/2016/05/Opioid-Conversions-May-3-2016-final.pdf •https://www.tga.gov.au/media-release/update-proposal-rescheduling-codeine-products •2009 opioid rotation expert panel review and guidelines - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065110/