Opioid Therapy for Chronic Pain: Risk Management Strategies

The use of opioids for chronic pain poses multiple challenges for nurse practitioners. While most clients with chronic pain can safely use these medications, there is a subset of patients who may exhibit aberrant behaviors during opioid therapy. These behaviors can indicate the possibility of drug diversion, substance abuse, or undertreated pain. Screening tools, opioid contracts, and urine drug testing may decrease clinician barriers to using opioids for chronic pain in primary care settings. The identification of at-risk patients before initiating opioids can optimize analgesia while safeguarding the legitimate use of these drugs to treat pain.