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Educational Activity

Strategies for Selecting Treatment and Mitigating Risk in Patients With Chronic Pain

Scott M. Fishman, MD

Published: January 15, 2011

This CME activity is expired. For more CME activities, visit
Find more articles on this and other psychiatry and CNS topics:
The Journal of Clinical Psychiatry
The Primary Care Companion for CNS Disorders

Article Abstract

Although opioid analgesics treat more types of pain and are usually more potent than other classes of analgesics, opioids are ineffective for some patients and can cause adverse physiologic or psychiatric effects in others. If a prescriber determines that opioid treatment is appropriate for a patient, opioid medications can be used chronically with both effectiveness and safety. Responsible opioid prescribing requires risk management, including assessing patients for abuse risk, identifying and measuring functional outcomes, and monitoring for adverse medication effects. Prescribers should follow the Federation of State Medical Boards model policy for using controlled substances and transparently document risk management when treating pain.

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