Chronic Pain Management: Best Practices - CME Paid Option-Lecture 5_Chronic Pain Management

Video Transcription

Video Summary

Dr. Don Stater, an addiction and emergency medicine physician, presents the fifth lecture in an eight-part series on opioid stewardship, focusing on best practices for chronic opioid therapy and pain management. The lecture outlines five key objectives: identifying appropriate candidates for chronic opioids, understanding naloxone prescribing, implementing monitoring to minimize risks, managing opioid misuse, and safely discontinuing opioids when necessary.<br /><br />He emphasizes the dual challenge of managing chronic pain—which affects 25-30% of Americans and has widespread negative health impacts—and the inherent risks of opioid therapy, including overdose, addiction, and adverse side effects. Dr. Stater stresses the importance of judicious, evidence-based prescribing, noting that opioid efficacy is well-established short-term but uncertain long-term.<br /><br />The approach includes thorough patient assessment (pain type, severity, and risk factors), risk stratification, and tailored risk mitigation strategies such as controlled agreements, regular monitoring, urine testing, and naloxone co-prescribing to prevent fatal overdoses. He highlights the need for clear treatment goals centered on function, use of validated tools like the PEG scale, and managing aberrant behaviors with patient-centered interventions rather than patient dismissal.<br /><br />Finally, he discusses the careful tapering or discontinuation of opioids when benefits wane or harm arises, advocating for supportive, consensual approaches to ensure patient safety and continuity of care. Dr. Stater thanks clinicians for their role in safe opioid stewardship and patient advocacy.

Keywords

opioid stewardship

chronic opioid therapy

pain management

naloxone prescribing

opioid misuse management

risk mitigation strategies

opioid tapering and discontinuation