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Quantum Units Education®

Opioid Safety Guidelines


1. Safe and effective chronic opioid therapy (COT) for chronic non-cancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and in the assessment and management of risks associated with aberrant opioid use-related behaviors.

A. True

B. False

2. FDA labels now state that extended-release and long-acting opioid analgesics are indicated “for the management of pain severe enough to require daily, around-the-clock opioid treatment and for which alternative treatments are inadequate” and caution clinicians to consider what an individual patient needs to:

A. Achieve relief with minimal side effects

B. Live and function better

C. Minimize additional complications that arise from poor pain management

D. None of the above

Prescribing Considerations

3. Experts recommend that clinicians prescribe long-acting pain medication to COT patients on an as-needed basis, and that they provide up to a six-month supply of pain medication for those who are stable.

A. True

B. False

Adverse Effects of Opioids

4. Opioids can cause sedation effect that cloud patients’ judgment and slow their reaction time, putting them at increased risk for falls and accidents while driving, using tools, or operating heavy equipment.

A. True

B. False

Adverse Effects of Opioids

5. Common side effects of opiates include each of the following EXCEPT:

A. Constipation, depression, and fatigue

B. Difficulty with urination and nausea or vomiting

C. Increased blood pressure and elevated heart rate

D. Heightened sensitivity to pain and impaired immune system

Management of Patients on COT

6. Urine drug screening (UDS) provides objective data regarding patients who are managing chronic pain, and can be used to:  

A. Hold patients accountable

B. Provide information to employers or members of law enforcement

C. Improve long-term outcomes by providing immediate information that can be used to adjust treatment plan

D. Directly improve patient safety

Table 3: Chronic Opioid Therapy Patient Groups

7. Which of the following is NOT one of the indicators that a patient may be having an issue adhering to an opioid-therapy treatment plan?

A. Frequent early refill requests

B. Escalating dose of between 80-100 MED/mg a day within a short period of time

C. Multiple emergency room/urgent care presentations for opioid treatment

D. Getting opioids from multiple prescribers

Tapering and Continuation

8. When a patient’s function and pain are not improved, tolerance has developed with long-term opioid prescription, or comorbidities increase risk of complication, it will likely be necessary to taper opioid therapy.

A. True

B. False

Treatment of Withdrawal Symptoms

9. Appropriate precautions must be taken to ensure safety when a patient is withdrawing from opioids, as opioid withdrawal it is generally very dangerous as well as unpleasant.

A. True

B. False

Table 6: Medications Used to Treat Symptoms During Gradual Taper

10. A non-FDA approved medication used as a first-line agent to treat hypertension, tremors, sweats, anxiety, and restlessness during opioid withdrawal and taper is:

A. Clonidine

B. Atropine

C. Methocarbamol

D. Hydroxyzine

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