Opioids and other medications (non-opioid analgesics, benzodiazepines, antidepressants, anticonvulsants, muscle relaxants) are prescribed to treat chronic pain of non-cancer origin. Ongoing monitoring of these patients is important to ensure safe and effective therapy. Drug testing is one tool utilized to identify patients who qualify for therapy and then to evaluate the continued effectiveness of pain relief; assess the potential for misuse, addiction or diversion; and ensure adherence to an agreed upon treatment plan.
For patients with chronic pain, opioids may offer important relief from suffering and help support activities of daily living. At the same time, if they are not used according to your prescription, opioids can do great harm. A prescription drug monitoring (PDM) program can help you maintain the maximum benefit of a patient’s opioid prescription, while minimizing the risks of misuse.
Physicians must take into account many factors when making decisions about opioid prescriptions, including the risk that the individual patient may divert prescription medications for illegal use. To aid physician decision-making, the state of Maine in 2013 instituted its Diversion Alert program, a program that gives physicians access to state records of arrests or summons for prescription or illegal drug-related crimes.
In 2016, the Centers for Disease Control published an updated guideline for primary care clinicians who are prescribing opioids for chronic pain (outside of active cancer treatment, palliative care, and end-of-life care). It’s an extensive study, with a thorough review of the evidence. But the main message is contained in 12 key points, summarized here.