Id: opioidcds-03 Url: Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy Version: 2022.1.0 Identifier: value: cdc-opioid-guidance Name: PlanDefinition_Recommendation_03_Order_Sign Title: Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule display: ECA Rule Date: 2025-07-01 Publisher: Centers for Disease Control and Prevention (CDC) Description: When starting opioid therapy for acute, subacute, or chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release and long-acting (ER/LA) opioids. Logic Definitions: Library Name Name sequence OpioidCDSREC03 Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions 0 define "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Subacute or Chronic Pain Prescription?"( AmbulatoryOpioidPrescription ) and AmbulatoryOpioidPrescription.medication in Common."Extended release opioid with ambulatory misuse potential" Library Name Name sequence OpioidCDSREC03 Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential 1 define "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" ) Library Name Name sequence OpioidCDSRoutines Patient Age Less Than 18 2 define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 else false Library Name Name sequence OpioidCDSRoutines Condition Positive for Sickle Cell 3 define "Condition Positive for Sickle Cell": if (Config."Sickle Cell Check Enabled") then exists( Common."Positive Sickle Cell Condition" ) else false Library Name Name sequence OpioidCDSRoutines Is Active Cancer Treatment? 4 define "Is Active Cancer Treatment?": if (Config."Active Cancer Treatment Encounters Condition Is Enabled") then "Has Two or More Encounters with Cancer Diagnosis During Encounter Period" or "Has Active Cancer Diagnosis on Problem List" else false Library Name Name sequence OpioidCDSRoutines Conditions Likely Terminal for Opioid Prescribing 5 define "Conditions Likely Terminal for Opioid Prescribing": if (Config."End-Stage Disease Criteria Enabled") then exists ( Common."US Core-Categorized Conditions" EOLC where EOLC.code in Common."Conditions likely terminal for opioid prescribing" // and EOLC.clinicalStatus in Common."Active Condition" ) else false Library Name Name sequence OpioidCDSRoutines Is Opioid Review Useful? 6 define "Is Opioid Review Useful?": not "Patient Age Less Than 18" and not "Condition Positive for Sickle Cell" and not "Is Active Cancer Treatment?" and not "Conditions Likely Terminal for Opioid Prescribing" Library Name Name sequence OpioidCDSRoutines Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days 7 define "Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid RX with Ambulatory Abuse Potential In Past 90 Days") else false Library Name Name sequence OpioidCDSRoutines Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days 8 define "Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days") else false Library Name Name sequence OpioidCDSRoutines Is Opioid Naive? 9 // NOTE: MedicationStatement-dependent logic comment out due to bug in Publisher not supporting MedicationStatement in AllTypes. define "Is Opioid Naive?": not ("Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days") /* and not ("Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ and not ("Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days") Library Name Name sequence OpioidCDSREC03 Inclusion Criteria 10 define "Inclusion Criteria": "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential" and Routines."Is Opioid Review Useful?" and Routines."Is Opioid Naive?" Library Name Name sequence OpioidCDSCommon US Core-Categorized Conditions 11 // 3. Medications indicating end of life /* or exists ( "Medications Indicating End of Life" ) */ define "US Core-Categorized Conditions": [Condition: category in "Encounter Diagnosis Condition Category"] union [Condition: category in "Problem List Condition Category"] union [Condition: category in "US Core Health Concern Condition Category"] Library Name Name sequence OpioidCDSCommon Conditions Indicating End of Life or With Limited Life Expectancy 12 define "Conditions Indicating End of Life or With Limited Life Expectancy": ( "US Core-Categorized Conditions" C where C.code in "Conditions likely terminal for opioid prescribing" and C.clinicalStatus in "Active Condition" ) union ( "US Core-Categorized Conditions" C where C.code in "Limited life expectancy conditions" and C.clinicalStatus in "Active Condition" ) Library Name Name sequence OpioidCDSCommon Admitted/Referred/Discharged to Hospice Care 13 define "Admitted/Referred/Discharged to Hospice Care": ( if (Config."Hospice Findings Exclusion Enabled") then [Observation: code in "Hospice Finding Codes"] O where not (O.status.value in { 'unknown', 'entered-in-error', 'cancelled' }) else {} ) union ( [Encounter] E where date from E.period.start 1 year or less on or before Today() and ( if E.hospitalization.dischargeDisposition.coding is null or not exists (E.hospitalization.dischargeDisposition.coding) then false else E.hospitalization.dischargeDisposition in "Hospice Disposition" ) and E.status.value in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' } ) Library Name Name sequence OpioidCDSCommon End of Life Assessment 14 define "End of Life Assessment": // 1. Conditions indicating end of life or with limited life expectancy exists ( "Conditions Indicating End of Life or With Limited Life Expectancy" ) // 2. Admitted/referred/discharged to hospice care or exists ( "Admitted/Referred/Discharged to Hospice Care" ) Library Name Name sequence OpioidCDSREC03 Exclusion Criteria 15 define "Exclusion Criteria": Common."End of Life Assessment" Library Name Name sequence OpioidCDSREC03 Is Recommendation Applicable? 16 define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria" Library Name Name sequence OpioidCDSCommon Is Opioid Analgesic with Ambulatory Misuse Potential? 17 define function "Is Opioid Analgesic with Ambulatory Misuse Potential?"(value List<MedicationRequest>): ("Get MedicationRequest Medication as Code"(value)) Rx where Rx.medication in "Opioid analgesics with ambulatory misuse potential" and Rx.category in "Community" Library Name Name sequence OpioidCDSCommon Get MedicationRequest Medication as Code 18 define function "Get MedicationRequest Medication as Code"(value List<MedicationRequest>): value Rx let Med: if Rx.medication is Reference then singleton from ( [Medication] M where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/'))) ) else null return MedicationRequest { id: Rx.id, status: Rx.status, intent: Rx.intent, category: Rx.category, medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept, subject: Rx.subject, authoredOn: Rx.authoredOn, recorder: Rx.recorder, dosageInstruction: Rx.dosageInstruction, dispenseRequest: Rx.dispenseRequest } Library Name Name sequence FHIRHelpers ToConcept 19 define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value } Library Name Name sequence OpioidCDSRoutines Is Subacute or Chronic Pain Prescription? 20 // End of Active Cancer Treatment Routine /* ** Routine #4 ** For Subacute or Chronic Pain Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ----------------------------------------------------------------------------------------------------------------------------------- ** Order for opioid analgesic | Yes | Order for opioid analgesics with ambulatory | Opioid analgesics with ** with expected supply | | misuse potential with a supply duration of >= | ambulatory misuse potential ** duration >= 28 days | | 28 days | ** | | | ** | | - Subacute definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of one to | ** | | two months. | ** | | - Chronic pain definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of >= two | ** | | months. | ** ----------------------------------------------------------------------------------------------------------------------------------- ** */ define function "Is Subacute or Chronic Pain Prescription?"(prescription FHIR.MedicationRequest): "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription) or "Is Subacute or Chronic Pain Using Validity Period"(prescription) Library Name Name sequence OpioidCDSRoutines Is Subacute or Chronic Pain Using Expected Supply Duration 21 define function "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.expectedSupplyDuration is not null and ( Common.GetDurationInDays(prescription.dispenseRequest.expectedSupplyDuration) >= 28 days ) ) Library Name Name sequence OpioidCDSCommon GetDurationInDays 22 define function GetDurationInDays(value FHIR.Duration): if value is null then null else case when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' } when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' } when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' } when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' } when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' } when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' } when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null') else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value) end Library Name Name sequence OpioidCDSRoutines Is Subacute or Chronic Pain Using Validity Period 23 define function "Is Subacute or Chronic Pain Using Validity Period"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.validityPeriod is not null and ( days between prescription.dispenseRequest.validityPeriod.start and prescription.dispenseRequest.validityPeriod.end >= 28 ) ) Library Name Name sequence FHIRHelpers ToDateTime 24 define function ToDateTime(value dateTime): value.value Knowledge Capability: shareable computable executable publishable Use Context: code value display focus 182888003 Medication requested (situation) focus 82423001 Chronic pain (finding) focus 274663001 Acute pain (finding) focus Purpose: The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care. Usage: Clinicians should not treat acute pain with ER/LA opioids or initiate opioid treatment for subacute or chronic pain with extended-release and long-acting (ER/LA) opioids, and clinicians should not prescribe ER/LA opioids for intermittent or as-needed use. Copyright: © CDC 2016+. Related Artifacts: Documentation 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain Libraries: Library - Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy Actions: When Initiating Opioid Therapy, Utilize Immediate Release Opioids: Recommend prescribing immediate release opioids instead of extended-release or long-acting opioids#xD; #xD; [For guidance regarding prescribing extended release/ long-acting opioids, see Recommendation 3 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation3). When: Named Event: order-sign If: Applicability: Check whether the current order is for an extended-release opioid with ambulatory misuse potential, the patient is opioid naive and if an opioid review is appropriate for the patient (Is Recommendation Applicable?) Then: : Document - Will prescribe immediate release opioid Then: : Snooze* - Benefits outweigh risks, snooze 3 months Then: : Snooze* N/A see comment, snooze 3 months Then:
Value set Opioid analgesics with ambulatory misuse potential
Value set Extended release opioid with ambulatory misuse potential
Value set Encounter Diagnosis Condition Category
Value set Problem List Condition Category
Value set US Core Health Concern Condition Category
Value set Conditions likely terminal for opioid prescribing
Value set Limited life expectancy conditions
Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
define "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Subacute or Chronic Pain Prescription?"( AmbulatoryOpioidPrescription ) and AmbulatoryOpioidPrescription.medication in Common."Extended release opioid with ambulatory misuse potential"
Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential
define "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" )
define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 else false
define "Condition Positive for Sickle Cell": if (Config."Sickle Cell Check Enabled") then exists( Common."Positive Sickle Cell Condition" ) else false
define "Is Active Cancer Treatment?": if (Config."Active Cancer Treatment Encounters Condition Is Enabled") then "Has Two or More Encounters with Cancer Diagnosis During Encounter Period" or "Has Active Cancer Diagnosis on Problem List" else false
Conditions Likely Terminal for Opioid Prescribing
define "Conditions Likely Terminal for Opioid Prescribing": if (Config."End-Stage Disease Criteria Enabled") then exists ( Common."US Core-Categorized Conditions" EOLC where EOLC.code in Common."Conditions likely terminal for opioid prescribing" // and EOLC.clinicalStatus in Common."Active Condition" ) else false
define "Is Opioid Review Useful?": not "Patient Age Less Than 18" and not "Condition Positive for Sickle Cell" and not "Is Active Cancer Treatment?" and not "Conditions Likely Terminal for Opioid Prescribing"
Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days
define "Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid RX with Ambulatory Abuse Potential In Past 90 Days") else false
Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days
define "Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days") else false
// NOTE: MedicationStatement-dependent logic comment out due to bug in Publisher not supporting MedicationStatement in AllTypes. define "Is Opioid Naive?": not ("Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days") /* and not ("Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ and not ("Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days")
define "Inclusion Criteria": "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential" and Routines."Is Opioid Review Useful?" and Routines."Is Opioid Naive?"
// 3. Medications indicating end of life /* or exists ( "Medications Indicating End of Life" ) */ define "US Core-Categorized Conditions": [Condition: category in "Encounter Diagnosis Condition Category"] union [Condition: category in "Problem List Condition Category"] union [Condition: category in "US Core Health Concern Condition Category"]
Conditions Indicating End of Life or With Limited Life Expectancy
define "Conditions Indicating End of Life or With Limited Life Expectancy": ( "US Core-Categorized Conditions" C where C.code in "Conditions likely terminal for opioid prescribing" and C.clinicalStatus in "Active Condition" ) union ( "US Core-Categorized Conditions" C where C.code in "Limited life expectancy conditions" and C.clinicalStatus in "Active Condition" )
Admitted/Referred/Discharged to Hospice Care
define "Admitted/Referred/Discharged to Hospice Care": ( if (Config."Hospice Findings Exclusion Enabled") then [Observation: code in "Hospice Finding Codes"] O where not (O.status.value in { 'unknown', 'entered-in-error', 'cancelled' }) else {} ) union ( [Encounter] E where date from E.period.start 1 year or less on or before Today() and ( if E.hospitalization.dischargeDisposition.coding is null or not exists (E.hospitalization.dischargeDisposition.coding) then false else E.hospitalization.dischargeDisposition in "Hospice Disposition" ) and E.status.value in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' } )
define "End of Life Assessment": // 1. Conditions indicating end of life or with limited life expectancy exists ( "Conditions Indicating End of Life or With Limited Life Expectancy" ) // 2. Admitted/referred/discharged to hospice care or exists ( "Admitted/Referred/Discharged to Hospice Care" )
define "Exclusion Criteria": Common."End of Life Assessment"
define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"
Is Opioid Analgesic with Ambulatory Misuse Potential?
define function "Is Opioid Analgesic with Ambulatory Misuse Potential?"(value List<MedicationRequest>): ("Get MedicationRequest Medication as Code"(value)) Rx where Rx.medication in "Opioid analgesics with ambulatory misuse potential" and Rx.category in "Community"
Get MedicationRequest Medication as Code
define function "Get MedicationRequest Medication as Code"(value List<MedicationRequest>): value Rx let Med: if Rx.medication is Reference then singleton from ( [Medication] M where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/'))) ) else null return MedicationRequest { id: Rx.id, status: Rx.status, intent: Rx.intent, category: Rx.category, medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept, subject: Rx.subject, authoredOn: Rx.authoredOn, recorder: Rx.recorder, dosageInstruction: Rx.dosageInstruction, dispenseRequest: Rx.dispenseRequest }
define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
Is Subacute or Chronic Pain Prescription?
// End of Active Cancer Treatment Routine /* ** Routine #4 ** For Subacute or Chronic Pain Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ----------------------------------------------------------------------------------------------------------------------------------- ** Order for opioid analgesic | Yes | Order for opioid analgesics with ambulatory | Opioid analgesics with ** with expected supply | | misuse potential with a supply duration of >= | ambulatory misuse potential ** duration >= 28 days | | 28 days | ** | | | ** | | - Subacute definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of one to | ** | | two months. | ** | | - Chronic pain definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of >= two | ** | | months. | ** ----------------------------------------------------------------------------------------------------------------------------------- ** */ define function "Is Subacute or Chronic Pain Prescription?"(prescription FHIR.MedicationRequest): "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription) or "Is Subacute or Chronic Pain Using Validity Period"(prescription)
Is Subacute or Chronic Pain Using Expected Supply Duration
define function "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.expectedSupplyDuration is not null and ( Common.GetDurationInDays(prescription.dispenseRequest.expectedSupplyDuration) >= 28 days ) )
define function GetDurationInDays(value FHIR.Duration): if value is null then null else case when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' } when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' } when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' } when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' } when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' } when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' } when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null') else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value) end
Is Subacute or Chronic Pain Using Validity Period
define function "Is Subacute or Chronic Pain Using Validity Period"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.validityPeriod is not null and ( days between prescription.dispenseRequest.validityPeriod.start and prescription.dispenseRequest.validityPeriod.end >= 28 ) )
define function ToDateTime(value dateTime): value.value
Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy
Centers for Disease Control and Prevention (CDC)
When starting opioid therapy for acute, subacute, or chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release and long-acting (ER/LA) opioids.
The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.
Clinicians should not treat acute pain with ER/LA opioids or initiate opioid treatment for subacute or chronic pain with extended-release and long-acting (ER/LA) opioids, and clinicians should not prescribe ER/LA opioids for intermittent or as-needed use.
2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain
When Initiating Opioid Therapy, Utilize Immediate Release Opioids
Recommend prescribing immediate release opioids instead of extended-release or long-acting opioids [For guidance regarding prescribing extended release/ long-acting opioids, see Recommendation 3 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation3).
Check whether the current order is for an extended-release opioid with ambulatory misuse potential, the patient is opioid naive and if an opioid review is appropriate for the patient
Document - Will prescribe immediate release opioid
Snooze* - Benefits outweigh risks, snooze 3 months
Snooze* N/A see comment, snooze 3 months