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Pain Management, Opioid Safety, and PDMP (PMOP)

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Opioid Safety

man & dog - with text VA commited to finding better ways to manage pain while limiting risk of long-term opioid therapy.

VA/DoD Clinical Practice Guidelines:
Management of Opioid Therapy (OT) for Chronic Pain (2022)

Image of VA_DOD Practice Guidelines

The 2022 guidelines describe 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.

 web link  Link to the VA/DoD Clinical Practice Guideline (CPG)

Disclaimer: This Clinical Practice Guideline is intended for use only as a tool to assist a clinician/healthcare professional and should not be used to replace clinical judgment.

About the Clinical Practice Guideline (CPG)   
The Clinical Practice Guideline is formatted as 20 evidence based recommendations and three clinical algorithms focused on:

   Module A: Determination of Appropriateness for Opioids for Chronic Pain
   Module B: Initiation of Treatment with Opioids
   Module C: Maintaining, Tapering, Discontinuing, or Switching from Full Agonist Opioids

Submit - Questions about the OT Guideline    
Guideline Links  Patient-Provider Tools  Related Guidelines 
OT Full Guideline (2022) OT Patient Summary (2022) Substance Use Disorder (SUD)
OT Provider Summary (2022)    
OT Pocket Card (2022)    

Opioid Safety Overview

The prescription opioid epidemic has required the VA to find better ways to manage pain in veterans while limiting the risks of opioids. A recent article, “Addressing the Opioid Epidemic in the United States: Lessons from the Department of Veterans Affairs” describes the system-wide strategies the VA has been employing since the launch of the Opioid Safety Initiative in 2013.  Click here to read the article on line - web link*

Collaborative Opioid Tapering

Guidelines are very clear about when patients should be tapered or weaned but are much less helpful with suggestions about how this will occur.  This video was produced by the VA and DoD to make this process a little easier for providers and a lot more helpful for patients. Common and challenging clinical interactions are depicted along with analyses of provider responses that facilitate collaboration, patient safety, and improved pain care.


Opioid Safety Initiative (OSI) & 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.  Get more information about Opioid Safety Initiative (OSI) & Toolkit. web link

Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients

A recent VA study comparing opioid and non-opioid therapy for pain demonstrated that opioids were not superior to non-opioid approaches in terms of efficacy but were associated with significant side effects. This is important information for clinicians to help with decisions related to pain care. It is also important information for patients who can be reassured that safer options for pain care may be equally effective and in some situations more effective.  Read more about this study.

Centers for Disease Control and Prevention (CDC) - Opioid

The web link CDC Opioid Overdose site contains useful information on opioids.

National Library of Medicine (NLM) - Opioid Addiction and Treatment Portal

NLM has released a new web portal on opioid addiction and treatment. It is available at: web link *

Opioids - Resource Topics of Interest

Clinical Tools Provider Education Veteran Public Education  Other Resources Opiod Safety 

Literature Alerts for VA Staff

The VA Library Network will provide VA staff an index of recent articles related to opioids and many other areas of interest right to your work mailbox. If you are interested in subscribing to this alert click here.

If you have questions or suggestions for pain-related resources, please send an email to VHA Pain Management Webmaster Group. Questions about personal care should be directed to the local VA facility.

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.