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My primary practice setting is:

I treat patients with chronic pain, as defined as pain lasting greater than 6 months or longer than expected

Please answer the following questions about your practice.

Please answer the following questions about your practice.
	Always	Almost Always	Sometimes	Rarely	Never
I would consider a trial of chronic opioid therapy in patients with moderate to severe pain in whom the pain is having an adverse effect on quality of life or functionality.
I discuss with each patient that this is a therapeutic trail, and individualize the therapy to each patient.
I regularly evaluate patients at high risk for abuse with urine drug screens and other methods to assess adherence to their prescribed medication regimen.
In patients at high risk of abuse I obtain psychiatric, physical medicine and rehabilitation or addiction specialist assistance with management.
I can identify common adverse side effects of chronic opioid therapy and counsel patients on effective therapies.
I regularly integrate psycho-therapeutic resources (counseling, cognitive behavioral therapy, psychiatry) in my treatment of patients on chronic opioid therapy.
I counsel patients on cognitive effects of chronic opioid therapy causing danger in the workplace and when driving.
I counsel women of childbearing years on the risks of chronic opioid therapy.
I am aware of the federal and state laws, regulatory guidelines, and policy statements governing the use of chronic opioid therapy.

Before initiation of chronic opioid therapy. . .

Before initiation of chronic opioid therapy. . .
	Always	Almost Always	Sometimes	Rarely	Never
I perform a history and physical examination on the patient.
I screen patients for risk of misuse, abuse, and addiction using validated tools.
I obtain informed consent from the patient which includes goals, expectations, risks, and alternatives to chronic narcotics.

I reassess patients regularly on chronic opioid therapy. . .

I reassess patients regularly on chronic opioid therapy. . .
	Always	Almost Always	Sometimes	Rarely	Never
. . . to document their pain intensity and assess progress towards reaching therapeutic goals.
. . .to evaluate for adverse effects.
. . . to evaluate for adherence to prescribed therapies.

I wean patients off of chronic opioid therapy that demonstrate. . .

I wean patients off of chronic opioid therapy that demonstrate. . .
	Always	Almost Always	Sometimes	Rarely	Never
. . .repeated aberrant drug-related behaviors or diversion.
. . .no progress towards meeting their goals.
. . .intolerable side effects.

I have read the AAFP Guidelines for Use of Opioids

If I identify patients with misuse or abuse of prescription medications, I have access to resources for those patients such as:

Thank you for your time and effort. I hope to use this as an opportunity to improve the resources available for you and your patients.