Opioid Stewardship in Practice: Safer Prescribing, Non-Opioid Strategies and Harm Reduction Across Care Settings-CME Paid Option-Module-3

Video Transcription

Video Summary

This microlearning reviewed opioid stewardship for chronic low back pain in rural primary care using Jennifer, a 49-year-old with persistent pain, fatigue, and poor sleep who uses intermittent tramadol. The main clinical goal is to shift care toward function, quality of life, and realistic expectations rather than complete pain elimination. Evidence supports using pain neuroscience education, NSAIDs, duloxetine when appropriate, and topical agents as low-risk options, while avoiding gabapentinoids when fatigue is a concern. Strongest non-pharmacologic strategies include movement, structured walking or exercise, CBT for insomnia, and brief, validating, patient-centered conversations. Clinicians should use shared decision-making, motivational interviewing, and tools like PEG-3 to track progress. If opioids are not helping, gradual tapering with collaboration is recommended. Overall, effective chronic pain care in resource-limited settings depends on combining education, movement, sleep support, and carefully selected non-opioid therapies.

Keywords

opioid stewardship

chronic low back pain

shared decision-making

pain neuroscience education

gradual opioid tapering