Question

A 45-year-old woman with chronic low back pain requests opioids for long-term management. She has tried NSAIDs and physiotherapy with limited benefit and has no history of substance use disorder. According to Canadian opioid prescribing guidance, what is the most appropriate next step?

Accepted Answer

Consider a trial of non-opioid and multidisciplinary therapies, and if opioids are considered, use the lowest effective dose with clear goals and monitoring

Answer

Start high-dose long-acting opioids immediately

Answer

Refuse any pain treatment

Answer

Suggest over-the-counter codeine without monitoring

Answer

Prescribe unlimited refills of short-acting opioids to be used as needed

Practice question

A 45-year-old woman with chronic low back pain requests opioids for long-term management. She has tried NSAIDs and physiotherapy with limited benefit and has no history of substance use disorder. According to Canadian opioid prescribing guidance, what is the most appropriate next step?