Strategies for selecting treatment and mitigating risk in patients with chronic pain.

Although opioid analgesics treat more types of pain and are usually more potent than other classes of analgesics, opioids are ineffective for some patients and can cause adverse physiologic or psychiatric effects in others. If a prescriber determines that opioid treatment is appropriate for a patient, opioid medications can be used chronically with both effectiveness and safety. Responsible opioid prescribing requires risk management, including assessing patients for abuse risk, identifying and measuring functional outcomes, and monitoring for adverse medication effects. Prescribers should follow the Federation of State Medical Boards model policy for using controlled substances and transparently document risk management when treating pain.