2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build

2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide, published by Centers for Disease Control and Prevention (CDC). This guide is not an authorized publication; it is the continuous build for version 2022.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/opioid-cds-r4/ and changes regularly. See the Directory of published versions

Library: OpioidCDSREC11OrderSelectLibrary (Experimental)

Official URL: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC11OrderSelect Version: 2022.1.0
Active as of 2025-08-19 Computable Name: OpioidCDSREC11OrderSelect
Id: OpioidCDSREC11OrderSelect
Url: Library - Recommendation #11 - Concurrent Use of Opioids and Benzodiazepines
Version: 2022.1.0
Name: OpioidCDSREC11OrderSelect
Title: Library - Recommendation #11 - Concurrent Use of Opioids and Benzodiazepines
Status: active
Experimental: true
Type:

system: http://terminology.hl7.org/CodeSystem/library-type

code: logic-library

Date: 2025-08-19 19:14:41+0000
Publisher: Centers for Disease Control and Prevention (CDC)
Related Artifacts:

Dependencies

Parameters:
NameTypeMinMaxIn/Out
ContextPrescriptionsMedicationRequest0*In
PatientPatient01Out
Opioid Analgesic with Ambulatory Misuse Potential PrescriptionsMedicationRequest0*Out
Benzodiazepine or CNS Depressant PrescriptionsMedicationRequest0*Out
Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potentialboolean01Out
Patient Is Being Prescribed Benzodiazepine or CNS Depressantboolean01Out
Inclusion Criteriaboolean01Out
Exclusion Criteriaboolean01Out
Is Recommendation Applicable?boolean01Out
Data Requirements:
TypeProfileMSCode Filter
Patient http://hl7.org/fhir/StructureDefinition/Patient
Content: text/cql
library OpioidCDSREC11OrderSelect version '2022.1.0'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers
include OpioidCDSCommon version '2022.1.0' called Common
include OpioidCDSCommonConfig version '2022.1.0' called Config
include OpioidCDSRoutines version '2022.1.0' called Routines

/*
**
**  Recommendation #11
**    Clinicians should use particular caution when prescribing opioid pain medication and benzodiazepines concurrently 
**    and consider whether benefits outweigh risks of concurrent prescribing of opioids and other central nervous system 
**    depressants  (recommendation category: B; evidence type: 3).
**
**  When
**    Provider is prescribing an opioid analgesic with ambulatory misuse potential in the outpatient setting or
**    Provider is prescribing a benzodiazepine or other central nervous system depressant medication
**    CDC 2022 guideline general inclusion criteria met for this patient:
**      Patient is 18 or over
**      Patient does not have evidence of sickle cell disease
**      Patient does not have findings indicating limited life expectancy
**      Patient does not have orders for therapies indicating end of life care
**      Patient is not undergoing active cancer treatment:
**        Patient has had at least 2 office visits within the past 12 months with an oncology specialist present, or
**        Patient has had at least 2 office visits within the past 12 months with a CDC malignant cancer condition diagnosis
**      Patient does not have conditions likely terminal for opioid prescribing present
**    Patient prescribed opioid analgesic with ambulatory misuse potential and benzodiazepine or other central nervous system depressant medication concurrently
**  Then
**    Use particular caution when prescribing opioid pain medication and benzodiazepines concurrently:
**      Document - Will modify prescription
**      Snooze - Benefits outweigh risks, snooze 3 months
**      Snooze - N/A see comment, snooze 3 months
**
*/

// META: Plan Definition: http://fhir.org/guides/cdc/opioid-cds-r4/PlanDefinition/opioid-cds-11-order-select

parameter ContextPrescriptions List<MedicationRequest>

context Patient

define "Opioid Analgesic with Ambulatory Misuse Potential Prescriptions":
  Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions )

define "Benzodiazepine or CNS Depressant Prescriptions":
  Common."Is Benzodiazepine or CNS Depressant?"( ContextPrescriptions )

define "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential":
  exists( "Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" )

define "Patient Is Being Prescribed Benzodiazepine or CNS Depressant":
  exists( "Benzodiazepine or CNS Depressant Prescriptions" )

define "Inclusion Criteria":
  (
    (
      "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential"
        and exists Common."Active Ambulatory Benzodiazepine or CNS Depressant Rx"
    )
      or (
        "Patient Is Being Prescribed Benzodiazepine or CNS Depressant"
          and exists Common."Active Ambulatory Opioid Rx"
      )
  )
    and Routines."CDC 2022 Guideline General Inclusion Criteria"

define "Exclusion Criteria":
  Common."End of Life Assessment"

define "Is Recommendation Applicable?":
  "Inclusion Criteria"
    and not "Exclusion Criteria"
Content: application/elm+xml
Encoded data (23060 characters)
Content: application/elm+json
Encoded data (36720 characters)