Table 1 Summary of CDC Guideline

1. Non-pharmacologic and non-opioid pharmacologic therapies are preferred

2. Establish and measure goals for pain and function

3. Discuss benefits and risks and clinician and patient responsibilities for managing opioid therapy

4. Use immediate-release opioids when starting

5. Carefully reassess benefit/risk when considering increasing dosage to ≥ 50 morphine milligram equivalents (MME)/day; avoid increasing dosage to ≥ 90 MME

6. When opioids are needed for acute pain, 3 days or less will often be sufficient; more than 7 days will rarely be needed

7. Follow-up and re-evaluate risk of harm within 1–4 weeks of a dose increase and at least every 3 months otherwise; reduce dose or taper and discontinue if harm outweighs benefit

8. Evaluate risk factors for opioid-related harms. Consider offering naloxone

9. Check Prescription Drug Monitoring Programs (PDMP)

10. Use urine drug testing at least annually

11. Avoid concurrent benzodiazepine and opioid prescribing

12. Arrange treatment for opioid use disorder if needed