VHA Pain Management
Opioid Safety Initiative (OSI)
Management of Opioid Therapy (OT) for Chronic Pain (2017) - VA/DoD Clinical Practice Guidelines
The guideline describes the critical decision points in the Use of Opioids in the Management of Chronic Pain and provides clear and comprehensive evidence based recommendations incorporating current information and practices for practitioners throughout the DoD and VA Health Care systems. The workgroup consensus statements are provided to minimize harm and increase patient safety in patients requiring opioid therapy.
Opioid Safety Initiative Toolkit
The VHA recognizes the clinical challenges to successfully managing pain and prescribing safely for our Veterans while implementing the Opioid Safety Initiative (OSI) Directive and the Informed Consent Directive. The National Pain Management Program office convened a national task force comprised of multidisciplinary pain exerts to create an OSI Toolkit (evidence-based to the extent possible) to help guide the field.
The resulting Toolkit contains documents and presentations that can aid in your clinical decisions about starting, continuing, or tapering opioid therapy, and other challenges related to safe opioid prescribing. We trust you will find these tools useful for your clinical teams caring for Veterans with chronic pain.
Opioid Safety Initiative Toolkit Material
- Newly Updated - Safe and Responsible Use of Opioids for Chronic Pain - A Patient Education Guide (PDF) - replacing; "Taking Opioids Responsibly for Your Safety and the Safety of Others."
- Acute Pain Provider Guide - Acute Pain Management Opioid Safety VA Educational Guide (2017) (PDF)
- Transforming the Treatment of Chronic Pain Moving Beyond Opioids - VA Clinician’s Guide (PDF)
- Pain Quick Reference Guide - Transforming the Treatment of Pain A Quick Reference Guide (2017) (PDF)
- Effective Treatments for PTSD: Consider Cognitive Behavioral Therapy (CBT) as First Line Treatment - for Clinicians (PDF)
- PTSD Overview – for Patients (PDF)
- Effective Treatments for PTSD: Helping Patients Taper from Benzodiazepines – for Clinicians (PDF)
- Benzodiazepines Overview - for Patients (PDF)
- Cognitive Behavioral Therapy for Chronic Pain - Therapist Manual (PDF)
- Newly Updated - Consent Form for Long-Term Opioid Therapy for Pain (Word)
- New - Methadone Fact Sheet (PDF)
If you have any questions or suggestions, please contact: Your VISN or facility Pain Point-of-Contact (POC) - through email Pamela Cremo - Pamela.Cremo@va.gov
Opioid Therapy Risk Report (OTRR)
OTRR is a patient-focused, actionable and provider-specific report that is available to Primary Care Providers (PCP), Primary Care Managers, PAC Teams, Clinical Pharmacists and others who need to identify patients receiving long-term Opioid Therapy (OT). Data are gathered Nationwide and updated daily so that the most recent information is available, regardless of where care was delivered. Data presented includes key variables that influence patient risk, such as PTSD, Substance Use Disorder (SUD) and Obstructive Sleep Apnea (OSA) as well as the most recent patient interaction with health providers such as Last PCP visit date, Last Pain Clinic visit date and last Mental Health visit date. Dates and status of the signed iMedConsentTM for Opioid Therapy are included. The Patient Details page contains results from the latest Urine Drug Test (UDT), Patient Pain Scores as well as patient Opioid and Benzodiazepine medication history tables listing the prescriber, dispensing location, strength, number of days supply and Morphine Equivalents.
National Library of Medicine (NLM) Opiate Addiction and Treatment Portal
NLM has released a new web portal on opiate addiction and treatment. Link to the site www.sis.nlm.nih.gov/enviro/addiction.html *
PCP and PAC Teams: Access the report using CPRS - Tools - PC Almanac
Opioids - Resource Topics
Disclaimer: *Links will take you outside of the Department of Veterans Affairs Website. VA does not endorse and is not responsible for the content of the linked websites.