||Opioid therapy for elderly patients can be safe and effective (Grade B) with appropriate precautions , including lower starting doses, slower titration, longer dosing interval, more frequent monitoring, and tapering of benzodiazepines (Grade C).
||Opioids present hazards for adolescents (Grade B). A trial of opioid therapy may be considered for adolescent patients with well-defined somatic or neuropathic pain conditions when non-opioid alternatives have failed, risk of opioid misuse is assessed as low, close monitoring is available, and consultation, if feasible, is included in the treatment plan (Grade C).
||Pregnant patients taking long-term opioid therapy should be tapered to the lowest effective dose
slowly enough to avoid withdrawal symptoms, and then therapy should be discontinued if possible (Grade B).
||Patients with a psychiatric diagnosis are at greater risk for adverse effects from opioid treatment. Usually in these patients, opioids should be reserved for well-defined somatic or neuropathic pain conditions. Titrate more slowly and monitor closely; seek consultation where feasible (Grade B).
||Co-morbid psychiatric diagnoses