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The most conservative addiction and overdose prevention policies and procedures can’t protect a primary care clinician from inheriting a patient who is taking high doses of opioids for chronic pain. In many cases, because of the patient’s limited resources or the limited number of specialists in the community, primary care clinicians are expected to satisfy the patient’s needs for specialty care, including pain management, mental health, and physical therapy. Although there is no perfect solution for clinicians faced with these challenging patients, the following recommendations can decrease the risk of overdose and increase the chance that patients can be transitioned to safer pain management:^*

Concurrent use of opioid pain medications, benzodiazepines, antihistamines, antipsychotics, antianxiety agents, or other CNS depressants increases a patient’s risk for overdose.¹

Terminating treatment of a chronic pain patient can become complicated, even when a patient agreement is signed and the termination letter is sent.¹