Nonopioid analgesics are first-line agents for pain; prescribe them alone for mild to moderate pain and in combination with opioids for severe pain. [14]
Regular exercise. Start small, gradually increase to at least 150 minutes/week at moderate intensity. Adjust this goal to the individual’s status.
Storage. Advise patients to store opioid medications in a secure location, preferably locked, that is away from household traffic. Opioids are a common reason for home invasion. Accidental ingestion by children and pets is also a concern.
Use established criteria to evaluate inappropriate opioid use by patients who are receiving long-term opioid therapy for chronic pain. Watch for red flag behaviors (Table 10).
Effective chronic pain management is focused on maximizing function and limiting disability, not just on reducing pain.
Some health conditions — for example, kidney disease, low blood pressure, heart rhythm problems or a history of seizures — may limit your options. Also, prescription sleeping pills and nonprescription sleep aids may interact with other medicines.
Pain intensity. A patient’s report of pain intensity provides a subjective gauge of the distraction and interference pain causes in their daily life.
If you fear the unknown or find yourself needing reassurance often, you may identify with this attachment style
Pregabalin is a get more info federal Schedule V controlled substance, and gabapentin has been scheduled in many states. Both of these medications produce an increased addiction risk.
But there are times when the addition of prescription sleeping pills may help you get some much-needed rest.
Fentanyl. Do not prescribe fentanyl for opioid naïve patients. Only consider prescribing fentanyl in a few unusual situations. Possible examples include: transdermal when gut mu receptors should be avoided; in head and neck cancer when oral intake is challenging; end of life care; intravenous in a patient with intrathecal “pain pump”; buccal and sublingual for episodic and breakthrough end-stage cancer pain.
Potential risks of opioid use for all patients include: physical adverse effects; cognitive impairment; social, personal, and family risks; failing urine screening; potential for opioid misuse.
“You’re the only person who can make yourself quit,” says Dr. Solanki. “You have control over what you put in your body.”
Ensure caregiver receives education on appropriate Intranasal Narcan use and administration to the patient if indicated