Opioid Stewardship in Practice: Safer Prescribing, Non-Opioid Strategies and Harm Reduction Across Care Settings-CME Paid Option-Compass CARES: Microlearning Series Handout

Compass CARES: Microlearning Series Handout

Pdf Summary

This document is a microlearning series on safer opioid prescribing and pain management in rural and community health settings. It uses four patient cases to teach practical, evidence-based strategies for chronic pain, postoperative pain, and overdose prevention.<br /><br />Key lessons include:<br />- Start opioids at the lowest effective dose and avoid rapid dose escalation.<br />- Focus treatment on function and quality of life, not just pain scores.<br />- Reassess whether opioids are helping mobility, sleep, and daily activities.<br />- Consider tapering when opioids no longer provide meaningful benefit, but do so slowly, collaboratively, and voluntarily.<br />- Use non-opioid and non-pharmacologic treatments first whenever possible, including physical therapy, exercise, sleep interventions, behavioral strategies, topical agents, duloxetine, acetaminophen, and NSAIDs when appropriate.<br /><br />In inpatient settings, the module emphasizes identifying high-risk patients early, especially older adults and those with sleep apnea, kidney disease, lung disease, or sedative use. It recommends multimodal, opioid-sparing care, including ERAS protocols, scheduled non-opioids, regional anesthesia, and non-drug comfort measures. Opioids should be reserved mainly for PRN breakthrough pain, with close monitoring for sedation and respiratory depression.<br /><br />For chronic outpatient pain, the series encourages realistic expectations, shared decision-making, and simple, low-cost interventions that work in rural settings, such as walking programs, sleep hygiene, and PEG-3 tracking.<br /><br />The overdose prevention module highlights “stacked risk” from opioids combined with benzodiazepines, alcohol, older age, or living alone. It recommends routine naloxone co-prescribing, PDMP review, urine drug testing, patient education, and nonjudgmental counseling.<br /><br />Overall, the series promotes patient-centered opioid stewardship: safer prescribing, harm reduction, and trust-building communication while preserving access to pain care.

Keywords

opioid prescribing

pain management

chronic pain

overdose prevention

naloxone

opioid stewardship

non-opioid treatments

regional anesthesia

PDMP review

shared decision-making