Useful Links

Opioid tools from the CDC:

https://www.cdc.gov/drugoverdose/prescribing/clinical-tools.html

 

Opioid patient education handout:

https://www.cdc.gov/drugoverdose/pdf/aha-patient-opioid-factsheet-a.pdf

 

Sample Opioid Consent and Agreement forms:

 

One page opioid informed consent form from Vermont:

https://www.healthvermont.gov/sites/default/files/documents/pdf/ADAP_EXAMPLE%20Acute%20Opioid%20Rx%20Informed%20Consent.pdf

 

Two page opioid agreement from Utah:

http://health.utah.gov/prescription/pdf/guidelines/treatment_plan.pdf

 

Other opioid agreements:

https://www.fda.gov/media/114694/download

https://www.drugabuse.gov/sites/default/files/SamplePatientAgreementForms.pdf

https://www.rxfiles.ca/rxfiles/uploads/documents/Pain-CNMP-Opioid-TreatmentAGREEMENT.pdf

https://www.drugabuse.gov/sites/default/files/SampleInformedConsentForm.pdf

https://nhms.org/sites/default/files/Pdfs/OpioidTxAgreement-2012Savage-Cheatle.pdf

https://nhms.org/sites/default/files/Pdfs/OpioidTxAgreement-VA2010.pdf

 

SBIRT tools: https://www.sbirt.care/

 

FDA Blueprint on ER/LA Opioids: 

https://wayback.archive-it.org/7993/20170112130317/http:/www.fda.gov/downloads/Drugs/DrugSafety/InformationbyDrugClass/UCM515636.pdf

Tennessee has set up their own guidelines, and they are good. This document includes sample informed consent forms and patient agreements, and many other items. https://www.tn.gov/content/dam/tn/health/healthprofboards/pain-management-clinic/ChronicPainGuidelines.pdf