Campaign for Meds Management Resource Page 16

Provider > Opioids > Assessments, Trackers, and Agreements

Acute & Chronic Pain Flow Sheets

Source: Oregon Pain Guidance

These flow charts can be used by providers to assist in the management of acute and chronic pain.

Adverse Drug Event Screening Tool

Source: Qualis Health

This is a one-page screening tool for providers to screen patients taking high-risk medications (opioids, anti-diabetics, and anticoagulants) for potential ADE and ADE. It is intended as a data collection tool (self-reporting medication safety), but also provides a basis for educating patients about potential adverse drug events associated with high risk medications.

Benzodiazepine & Opioid Tapering Flow Sheet

Source: Oregon Pain Guidance

This flow chart can be used by providers to assist in getting patients off of benzodiazepine and opioid medications.


Source: Richard Brown, MD

The CAGE-AID is a questionnaire to screen for risks of alcohol and drug abuse conjointly, rather than separately.

Calculating Daily Morphine Milligram Equivalents

Source: Prescription Drug Monitoring Program Training and Technical Assistance Center

Report with downloadable conversion charts in opioid prescription.

Clinical Opiate Withdrawal Scale (COWS)

Source: National Institute on Drug Abuse

This tool can be used in both inpatient and outpatient settings to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed score for the complete scale can be used to help clinicians determine the stage or severity of opiate withdrawal and assess the level of physical dependence on opioids.

Current Opioid Misuse Measure

Source: Inflexxion, Inc.

The Current Opioid Misuse Measure (COMM)™ is a brief patient self-assessment to monitor chronic pain patients on opioid therapy.

D.I.R.E Score: Patient Selection for Chronic Opioid Analgesia

Source: Fairview Pain & Palliative Care Center

This scoring document assists providers in determining if treatment with a long-term opioid analgesic medication is appropriate for a patient.

ESP Tools

Source: Emerging Solutions in Pain

Emerging Solutions in Pain (ESP) addresses some of today's most critical issues in pain management. Through evidence-based scientific data, validated tools, and the expertise of leading pain and addiction medicine experts, the ESP program provides clinicians with guidance in the implementation of good practice management techniques. This website provides access to ESP's validated tools.


Source: SAMHSA

MATx empowers healthcare practitioners to provide effective, evidence-based care for opioid use disorders. This free app supports practitioners who currently provide medication-assisted treatment (MAT), as well as those who plan to do so in the future.

Opioid Guideline App

Source: CDC

This is an app available both on Google Play and the Apple Store for professionals to refer to the opioid prescribing guidelines.

Opioid Intervention Idea Checklist

Source: Telligen

This document provides various opioid intervention options to improve opioid safety and associated quality improvement approaches to assess effectiveness of the chosen interventions.

Opioid Risk Tool

Source: Mountain Pacific

The Opioid Risk Tool (ORT) is a brief, self-report screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain. This tool should be administered to patients upon an initial visit prior to beginning opioid therapy for pain management.

Opioid Risk Tool (ORT)

Source: MDCalc

This is an online scoring tool to help providers determine a patient's risk for opioid use disorder or overdose.

OTC Oral Analgesic Selection and Patient Education

Source: American Pharmacist Association (APhA)

This algorithm is provided as a resource to guide pharmacists in assessing patient complaints of pain, selecting analgesics that are appropriate for individual patients, and educating patients about appropriate OTC analgesic use.

Pain Management Discharge Communication (Audit Tool)

Source: AQIN

The Pain Management Discharge Communication Audit tool list the elements that should be communicated to subsequent providers during care transitions. The elements were developed via expert consensus and the audit tools can help facilities identify and resolve communication flaws which may contribute to high-risk medication-related adverse drug events. These tools can be used in any care setting (hospital, skilled nursing facility, home healthcare, etc.).

 Prescriber and Patient Treatment Agreement

Source: Beneficiary Developed

This agreement was created with patient input on content and can be used to clearly document both patient and provider responsibilities during pain management. This can be used as a "pain contract" as it allows signatures and agreements about pain treatment plans.

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