• Phys Med Rehabil Clin N Am · May 2020

    Review

    Opioid Management: Initiating, Monitoring, and Tapering.

    • W Michael Hooten.
    • Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Charlton 1-145, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: hooten.william@mayo.edu.
    • Phys Med Rehabil Clin N Am. 2020 May 1; 31 (2): 265-277.

    AbstractNumerous guidelines targeting safe use of opioids for chronic pain have been published but substantial challenges persist in clinical application of best practice recommendations. This article describes a pragmatic approach to clinical care of adults with chronic pain receiving long-term opioid therapy. Three components of care are emphasized: (1) medical and mental health assessment before initiating opioid therapy, (2) clinical surveillance during the course of long-term opioid therapy, and (3) clinical considerations and strategies governing opioid tapering. A pressing need exists for ongoing research to further clarify the optimal role that long-term opioid therapy has in treatment of chronic pain.Copyright © 2020 Elsevier Inc. All rights reserved.

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