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

PlanDefinition: Recommendation #10 - Urine Drug Testing (order-select) (Experimental)

Official URL: http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-10-order-select Version: 2022.1.0
Draft as of 2025-03-19 Computable Name: PlanDefinition_Recommendation_10_Order_Select
Other Identifiers: cdc-opioid-guidance (use: official, )

Copyright/Legal: © CDC 2016+.

When prescribing opioids for subacute or chronic pain, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances.

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.

Id: opioidcds-10-order-select
Url: Recommendation #10 - Urine Drug Testing (order-select)
Version: 2022.1.0
Identifier:

value: cdc-opioid-guidance

Name: PlanDefinition_Recommendation_10_Order_Select
Title: Recommendation #10 - Urine Drug Testing (order-select)
Status: draft
Experimental: true
Type:

system: http://terminology.hl7.org/CodeSystem/plan-definition-type

code: eca-rule

display: ECA Rule

Date: 2025-03-19
Publisher: Centers for Disease Control and Prevention (CDC)
Description: When prescribing opioids for subacute or chronic pain, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances.
Knowledge Capability: shareable computable executable publishable
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: Before starting opioids and periodically (at least annually) during opioid therapy, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed opioids and other prescription and nonprescription controlled substances that increase risk for overdose when combined with opioids, including nonprescribed and illicit opioids and benzodiazepines.
Copyright:

© CDC 2016+.
Related Artifacts:

Documentation
Libraries:
OpioidCDSREC10OrderSelect
Actions:
Consider Urine Drug Screen (UDS): <ul><li>Urine drug screening should be done at least 1-2 times a year</li><li>Screening frequency should be based on assessed risk, guidelines, and regulations</li><li>UDS monitors opioid adherence and detects non-prescribed substances for patient safety</li><li>Confirmatory testing may be helpful; results may be affected by drug metabolism and dose timing</li><li>Discuss concerns with the patient before making therapeutic changes</li></ul>
When: Named Event: order-select
If: Applicability: Patient has not had a urine screening in the past 12 months (Is Perform Drug Screen Recommendation Applicable?)
Then:
UDS 1 :
Then: Definition: ActivityDefinition[http://fhir.org/guides/cdc/opioid-cds/ActivityDefinition/opioidcds-urine-screening-request-1|2022.1.0]
UDS 2 :
Then: Definition: ActivityDefinition[http://fhir.org/guides/cdc/opioid-cds/ActivityDefinition/opioidcds-urine-screening-request-2|2022.1.0]
:
Then:
:
Then:
:
Then:
:
Then:
Patient May Have Unexpected Toxicology Test Results: Patient may have unexpected urine toxicology test results in the past year
When: Named Event: order-select
If: Applicability: Patient may have unexpected urine toxicology test results in the past year (Applicable Because of Unexpected Results)
Then:
:
Then:
:
Then: