Starting Opioids

Creating and Using a Treatment Plan

It is important that opioid therapy be offered as part of a larger treatment plan that may encompass other, non-pharmacological interventions. These may include:

  • Regular exercise.
  • Stress management techniques.
  • Meditation.
  • Physical therapy.
  • Cognitive-behavioral therapy.


The treatment plan should also include a review of expectations, including:

  • Regular attendance at all appointments.
  • Pill counts.
  • Urine drug testing.
  • The use of only one provider and pharmacy to receive prescription medications.
  • Refill and renewal policies.


When developing a treatment plan, it may be helpful to assess the following areas:

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Sources: These recommendations are based on expert consensus, as well as the following articles:

Gourlay DL, Heit HA, Almahrezi A. Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med. 2005 Mar-Apr;6(2):107-12.

Nicolaidis C. Police officer, deal-maker, or health care provider? Moving to a patient-centered framework for chronic opioid management. Pain Med 2011;12(6):890-897.