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Pain Guidelines

Chronic pain and prescription opioid misuse are both major public health problems that exist across the continuum of care. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. These principles and guidelines aim to identify and promote the essential elements of acute, chronic and palliative pain assessment and management for both children and adults, as well as recognize the risks of opioid use disorder.

Community Principles of Pain Management

The Community Principles of Pain Management provide recommendations for primary care clinicians who are assessing, managing and prescribing treatment, including opioids, for acute, chronic pain and active cancer treatment, palliative care, and end-of-life care. The principles were revised to align with national guidelines developed by a panel of experts and aim to help clinicians meet federal and state regulations.

Complete Pain Toolkit

The complete pain toolkit contains all the professional resources of the Community Principles of Pain Management (CPPM), revised and approved in 2017.

Individual Tools

The individual professional resources contained in the complete CPPM pain toolkit are available to assist the clinicians with effective pain management.








Opioid Use Disorder

Prescription drug abuse continues as a health care problem in our nation and state.  Despite the fact that the NYS PDMP (Prescription Drug Monitoring Program), has yielded a  75% improvement in “doctor shopping” for opioid prescriptions, since 2013, death by overdose on prescription opioids remains significant in NYS.

CDC Guideline for Prescribing Opioids for Chronic Pain

The CDC guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. Additional tools are found on the CDC website.




 National Guidelines

Opioids are not first line for chronic pain, even moderate to severe pain, which should be managed with an active approach and non-opioid pain relievers whenever possible.  When opioids are indicated, based on a careful risk assessment, combine with an active approach and other measures. Be wary of dose escalation over time due to tolerance.




Acknowledgement

The Community Principles of Pain Management (CPPM) were developed by the CPPM Specialty Advisory Group (SAG) initially in 2002, and are reviewed and approved every other year by the SAG. The CPPM were approved by the Excellus BlueCross BlueShield Health Care Quality Monitoring Committee and the Monroe County Medical Society Quality Collaborative in April 2017, with the next revision scheduled for 2019. Special thanks to the 2017 Special Advisory Group (SAG).

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