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Opioid Management Established Patient Checklist

Assessment

H&P/ ROS completed by provider

Patient assessment completed

Medication Assessment

Current medications reviewed

PDMP checked

Checked ofor Opiate, Benzodiazepine, other legal drug cocktails

Diagnostics, Alternative Treatments and Medical Necessity

What diagnostics have been performed?

What alternative therapies or treatments have been tried?

Medical necessity has been established

Referral and/or Consultation

Consider referral to pain clinic

Other consult: neuro, psychologic, surgeon, alternative, etc.

Set Goals

Both functional and reduction of pain

Reduction of opiate dose

Re-Check

ABC checklist

Algorithm for low, med, high risk

Assess goal progress