Opioid Addiction-- Trauma or Surgery

From Clinicaltools.com

Contents 1 Course 5: Preventing Opioid Addiction In the Treatment of Backache, Arthritis, Headache, Neuropathy, and Acute Pain from Trauma or Surgery 1.1 Need 1.2 Goal 1.3 Objectives 1.3.1 Determine when opioids are appropriate therapy for common conditions and who should prescribe them 1.3.2 Use Opioids Appropriately for Treating Simple Backache [1] 1.3.3 Use Opioids Appropriately for Treating Arthritis (Gibofsky et al, 2008)[2] 1.3.4 Use Opioids Appropriately for Treating Headache (Ziegler, et al, 2003) 1.3.5 Use Opioids Appropriately for Treating Neuropathy Eisenberg 2006[3] 1.3.6 Use Opioids Appropriately for Treating Pain From Acute Trauma/Post-Surgery 1.4 Case Study/Simulated Patients - IN DEVELOPMENT

Course 5: Preventing Opioid Addiction In the Treatment of Backache, Arthritis, Headache, Neuropathy, and Acute Pain from Trauma or Surgery

Need

Clinicians need to avoid triggering or contributing to an addiction problem when managing pain caused by backache, arthritis, headache, neuropathy, and acute pain from trauma or surgery, the most common conditions for which opioids are prescribed in primary care.

Goal

The learner will manage the conditions for which opioids are prescribed most often in primary care, in a way that avoids triggering or contributing to addiction problems.

Objectives

After completing this course, the learner will be able to:

Determine when opioids are appropriate therapy for common conditions and who should prescribe them

1. Utilize non-opioid pharmacotherapy and other therapies for the majority of backache, arthritis, headache, neuropathy and acute trauma/post-surgical patients
2. Recognize the uncommon situation in which opioids are indicated for treatment of backache, arthritis, headache, and neuropathy patients and acute pain from trauma or surgery
3. When opoiods are indicated, use in combination with other pharamacological and non-pharmacological therapies in order to minimize the dose and increase effectiveness
4. Identify yellow flags in patients with common pain conditions that suggest opioids should be prescribed with caution
5. Refer for evaluation by a pain specialist patients who require opioid therapy for common conditions and who exhibit "yellow flags"

Use Opioids Appropriately for Treating Simple Backache [1]

1. Use non-opioid treatments in order: paracetamol, NSAIDs) and non-pharmacological treatments (maintain activity, exercise) as first-line treatment
2. Use paracetamol in combination with a weak opioid compound if first line treatments fail
3. Use a muscle relaxant when appropriate
4. Use strong opioids only if the above treatments fail and for no longer than 2 weeks in combination with other pharamacological and non-pharmacological treatment
5. (address other special considerations for backache)

Use Opioids Appropriately for Treating Arthritis (Gibofsky et al, 2008)[2]

1. Use first line medications before use of extended release opioids (order: acetominophen, NSAIDS, cox-2 inhibitors) to treat osteoarthritis
2. Use first line medications on a schedule rather than as needed to treat osteoarthritis
3. Determine when to use extended release opioids for severe pain due to osteoarthritis
4. Use unscheduled extended release opioids (e.g. tramadol) before scheduled ones
5. Determine which scheduled extended release opoioids to use and in combination with what other medications to treat osteoarthritis
6. (address other special considerations for arthritis)

Use Opioids Appropriately for Treating Headache (Ziegler, et al, 2003)

1. (address special considerations for headache)

Use Opioids Appropriately for Treating Neuropathy Eisenberg 2006[3]

1. (address special considerations for neuropathy)

Use Opioids Appropriately for Treating Pain From Acute Trauma/Post-Surgery

1. (address special considerations for trauma and surgery)

Case Study/Simulated Patients - IN DEVELOPMENT