Safe Opioid Prescribing for Adults by Nurse Practitioners: Part 2. Implementing and Managing Treatment

• Describes nationally vetted standards of practice for safe opioid prescribing.
• Details reviewing prescription drug monitor reports, urine drug tests, informed consents, and patient and provider agreements.
• Discusses application of opioid misuse risk assessment tools.
• Presents common behavioral red flags that can alert providers to a potential misuse problem.
• Discusses mitigation strategies for safe opioid prescribing to problem patients.

Opioid use for treating pain is based on a thorough pain-focused history and assessment and begins as a trial. It continues with ongoing monitoring using intermittent risk assessments, urine drug tests, prescription drug monitoring reports, informed consents, and patient provider agreements. These inform providers and patients about treatment choices, responsibilities of each person, and consequences that could result if misuse occurs. Nurse practitioners have a professional responsibility to follow state and national guidelines and to be aware of best practices for safe opioid prescribing to protect patients, the public, and themselves if they become the subject of an investigation.