The American Society of Interventional Pain Physicians (ASIPP) had released its Opioid Guidelines for Responsible Prescribing in Chronic Non-Cancer Pain. As part its professional journal, the Pain Physician, ASIPP has created and revised guidelines for interventional techniques and opioid prescribing since 2002. The latest guidelines released today are comprehensive is a product of a multidisciplinary panel of 55 authors. These guidelines illustrate a 10-step process with comprehensive assessment and documentation, establishing medical necessity and treatment goals, recommendations for responsible opioid therapy with dose limitations, and necessity for a comprehensive and robust agreement. The guidelines include the initial steps for comprehensive assessment, including the risk assessment, steps to appropriate diagnosis, establishing medical necessity, establishing treatment goals, assessing effectiveness of opioid therapy; with informed decision making, initial treatment steps, adherence monitoring, evaluation of side effects and discontinuation or maintenance of opioid therapy on a long-term basis. It also covers the means and ways to initiate opioid therapy, specific guidelines for methadone use, and reduction in prescription drug dose.
These comprehensive two-part guidelines provide guidance on dose limitations with low dose being defined as 40 mg, moderate dose, up to 90 mg of morphine equivalence, and high dose as anything over 90 mg of morphine equivalence.