Implementing Pain Management Policies and Procedures at a Rural Pain Clinic

Abstract

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural pain clinic which placed patients at higher risk of developing opioid use disorder. Multiple interventions were implemented at this clinic which included the opioid risk tool (ORT) to screen patients for their level of risk for developing opioid use disorder, increasing the number of random drug screens, pain management contracts, and consistent use of the prescription drug monitoring system (PDMS). During the project implementation phase 218 ORTs were completed, the PDMS was accessed 288 times, 80 pain contracts were signed, 25 random drug screens, and 10 yearly urine drug screens were completed. Pain clinic staff quickly adopted the interventions of administering the ORT and checking the PDMS. Pain contract administration was slowly accepted but completing random and yearly drug screens was not fully implemented by clinic staff