Guidelines for Prescribing Pain Medications™
STATEMENT OF PURPOSE
The rampant abuse of opioid medications has necessitated a dramatic change in the way healthcare providers consider managing pain after a procedure , or as part of ongoing treatment . Prescription pain medications containing opioids are a part of a variety of pain management strategies . While much has been done to decrease the patterns of over-prescribing pain medications , these recommendations are provided to help clinicians ’ decision making , specifically regarding the use of narcotic-based pain medications . It is very clear that several non-addictive alternative analgesics are as effective as opioid pain medications in many situations and are almost always preferred for patients undergoing outpatient procedures . These alternatives , such as NSAIDS and acetaminophen may avoid the risk of addiction , or the side effects associated with opioids . While it is recognized that narcotics can and should be avoided in most outpatient scenarios , clinical judgment should always be applied when making decisions and individual care should be based on many factors . Exceptions are inevitable but should be rare .
The Guidelines for Prescribing Pain Medications ( The Guidelines ) established conservative protocols for prescribing pain medication following performed procedures at The University of Pittsburgh School of Dental Medicine and our affiliates . However , we invite all conscientious healthcare providers to adopt The Pain Care Pledge and The Guidelines .
GUIDELINES FOR RESPONSIBLE PAIN MANAGEMENT
In the process of delivering care and assessing postoperative pain , the prescriber should try to estimate the severity , duration , and patient ’ s individual risk when prescribing pain medications . For example , the simpler the procedure ( e . g ., routine versus surgical extractions ), the less likely the patient will suffer severe post-operative pain . In addition , individual patient characteristics may alter patient thresholds for pain or increase sensitivity to opioids ( e . g ., advanced age , history of substance abuse , obstructive sleep apnea , concomitant use of benzodiazepines , or other drugs that may cause respiratory depression or mental status changes ). Pain is multifactorial and it is up to the healthcare provider to make informed and consultative decisions with their patient regarding what medications are indicated and appropriate in each clinical scenario .
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Providers should prescribe pain medication other than opioids as first-line analgesic therapy , unless contraindicated .
The Patient ’ s Prescription Drug Monitoring Program ( PDMP ) database should be reviewed as per Commonwealth regulations if considering an opioid prescription .
22 MARCH / APRIL 2022 | PENNSYLVANIA DENTAL JOURNAL