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Smaller TextCanadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain
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[Apple iTunes App]The Canadian Guideline is presented in two separate documents: Part A (Executive Summary and Background) and Part B (Recommendations for Practice). PDF versions posted on this website are the official Canadian Guideline documents. Web formatted content is the unofficial version of the Guideline. While best efforts have been made to ensure accuracy and consistency with the official documents, if any discrepancies exist in the web format, content of the PDF version shall apply. Please feel free to download the PDF files of the Canadian Guideline documents.
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Overview of the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain
- Summary of
Recommendations
- Part A:
ExecutiveSummary
and Background - Appendix A
- Part B:
Recommendations
for Practice - Appendix B
- List of Figures
and Tables
Summary of Recommendations
- Cluster 1: Deciding to Initiate Opioid Therapy
- Cluster 2: Conducting an Opioid Trial
- Cluster 3: Monitoring Long-Term Opioid Therapy (LTOT)
- Cluster 4: Treating Specific Populations with LTOT
- Cluster 5: Managing Opioid Misuse and Addiction in CNCP Patients
When referencing the Canadian Opioid Guideline use the following format:
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. Canada: National Opioid Use Guideline Group (NOUGG); 2010 [cited year month date]. Available from: http://nationalpaincentre.mcmaster.ca/opioid/
Part A: Executive Summary and Background
- Core Concepts
- Funding
- Scope
- Limitations
- Canadian Guideline Inception
- Players Involved in Development
- Epidemiology of Chronic Non-Cancer Pain (CNCP)
- Need for a Guideline on Opioid Use and CNCP
- Implementation to Practice
- Literature Search Methods
- National Advisory Panel (NAP) Consultation
- Updating
- Comparison with Other Guidelines
- Topics for Future Research
When referencing the Canadian Opioid Guideline use the following format:
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. Canada: National Opioid Use Guideline Group (NOUGG); 2010 [cited year month date]. Available from: http://nationalpaincentre.mcmaster.ca/opioid/
Appendix A
- Appendix A-1: National Opioid Use Guideline Group (NOUGG)
- Appendix A-2: Research Group
- Appendix A-3: National Advisory Panel (NAP)
- Appendix A-4: Literature Search Strategies
- Appendix A-5: Flowchart of Literature Review Process
- Appendix A-6: NOUGG Criteria for Recruiting NAP Members
- Appendix A-7: Disclosure of Conflict of Interest Form
- Appendix A-8: Modified Delphi Process used in NAP Consultation Rounds 2 to 4
- Appendix A-9: NAP Electronic Response Survey Tool
When referencing the Canadian Opioid Guideline use the following format:
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. Canada: National Opioid Use Guideline Group (NOUGG); 2010 [cited year month date]. Available from: http://nationalpaincentre.mcmaster.ca/opioid/
Part B: Recommendations for Practice
Canadian Guideline Recommendations
- Cluster 1: Deciding to Initiate Opioid Therapy
- Cluster 2: Conducting an Opioid Trial
- Cluster 3: Monitoring Long-Term Opioid Therapy (LTOT)
- Cluster 4: Treating Specific Populations with LTOT
- Cluster 5: Managing Opioid Misuse and Addiction in CNCP Patients
Figures
When referencing the Canadian Opioid Guideline use the following format:
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. Canada: National Opioid Use Guideline Group (NOUGG); 2010 [cited year month date]. Available from: http://nationalpaincentre.mcmaster.ca/opioid/
Appendix B
- Appendix B-1: Examples of Tools for Assessing Alcohol and other Substance Use
- Appendix B-2: Opioid Risk Tool
- Appendix B-3: Urine Drug Screening (UDS)
- Appendix B-4: Opioid Information for Patients
- Appendix B-5: Sample Opioid Medication Treatment Agreement
- Appendix B-6: Benzodiazepine Tapering
- Appendix B-7: Example of Documenting Opioid Therapy
- Appendix B-8: Opioid Conversion and Brand Availability in Canada
- Appendix B-9: Brief Pain Inventory ©
- Appendix B-10: Aberrant Drug-Related Behaviours Resources
- Appendix B-11: SOAPP®-R and COMM®
- Appendix B-12: Opioid Tapering
- Appendix B-13: Meta-analysis Evidence Table
When referencing the Canadian Opioid Guideline use the following format:
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. Canada: National Opioid Use Guideline Group (NOUGG); 2010 [cited year month date]. Available from: http://nationalpaincentre.mcmaster.ca/opioid/
List of Figures and Tables
- Figure 01. Recommendations Roadmap
- Table A-10.3.1 National Advisory Panel Participation in Modified Delphi Process
- Table A-10.3.2 Recommendation Grading
- Table A-11.3 NAP Consultation Tasks and Outcomes
- Table A-11.4 NAP-Response Dominant Themes and Modifications
- Table B-3.1 Interpreting Unexpected Results of Urine Drug Screens
- Table B-4.1 Evidence of Opioid Efficacy
- Table B-5.1 Adverse Effects of Opioids
- Table B-5.2 Opioid Risks
- Table B-8.1 Stepped Approach to Opioid Selection
- Table B-8.2 Safety Issues to Consider When Selecting Opioids
- Table B-8.3 Other Formulations and Preparations
- Table B-9.1 Opioid Suggested Initial Dose and Titration
- Table B-10.1 Morphine Equivalents for Strong Opioids used in Randomized Controlled Trials
- Table B Appendix 3.1 Immunoassay versus Chromatography for Detection of Opioid Use
- Table B Appendix 3.2 Detection Times for Immunoassay and Chromatography
- Table B Appendix 6.1 Benzodiazepine Equivalent Table
- Table B Appendix 8.1 Oral Opioid Analgesic Conversion Table
- Table B Appendix 10.1 Aberrant Drug-Related Behaviours Indicative of Opioid Misuse
When referencing the Canadian Opioid Guideline use the following format:
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. Canada: National Opioid Use Guideline Group (NOUGG); 2010 [cited year month date]. Available from: http://nationalpaincentre.mcmaster.ca/opioid/
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