Patient selection: non-cancer pain
Types of opioid therapy:
(1) acute
(2) episodic
(3) long-term
(3a) lower dose
(3b) higher dose
Features of an acute episode profile:
(1) 12-14 days (brief)
(2) limited days dispensed (7-9 days)
(3) average daily dose 55 mg morphine equivalent
Features of episodic use:
(1) duration around 180 days
(2) mean days supply 28-29
(3) average daily dose 5-6 mg
Criteria for defacto long-term opioid therapy - both of the following:
(1) duration of opioid use > 90 days
(2) at least 10 opioid prescriptions and/or days supply dispensed >= 120 days
Features of long-term higher dose episodes:
(1) daily or near daily use
(2) mean duration 1,000 days
(3) total days supply mean 850 days
(4) average daily dose 55 mg morphine equivalent
(5) average prescribed dose 60-70 mg morphine equivalent
Features of long-term lower dose episodes:
(1) intermittent use
(2) mean duration 850 days
(3) total days supply less than 50% of episode duration
(4) average daily dose 8-9 mg morphine equivalent
(5) average prescribed dose 24-30 mg morphine equivalent
