Sample Pain Management Agreement
Edit this sample agreement as needed to use in your clinical practice.
Assessment Tools for Co-morbid Mood Disorders Assessment Tools for Co-morbid Mood Disorders Assessment Tools for Pain & Related Conditions Co-Occurrence of Mental Health Disorders & Substance Use Disorders
Patient Health Question (PHQ-9)
9 item depression assessment to determine severity of depressive symptoms and indicate if a depressive disorder should be considered.
Assessment Tools for Co-morbid Mood Disorders Co-Occurrence of Mental Health Disorders & Substance Use Disorders
Generalized anxiety scale (GAD) –GAD 7
Screening tool that identifies if a complete assessment for anxiety is recommended.
Assessment Tools for Pain & Related Conditions Opioid-Specific Risk Assessments Screening Tools for Substance Use and Opioid Use Disorders
Current Opioid Misuse Measure (COMM)
A brief, 17-item patient self-assessment to monitor chronic pain patients on opioid therapy and to determine if patients already on long-term opioid treatment are exhibiting aberrant medication-related behaviors.
Assessment Tools for Pain & Related Conditions Opioid-Specific Risk Assessments Screening Tools for Substance Use and Opioid Use Disorders Substance Use Disorder and Opioid Use Disorder Assessment Tools
COWS
Assess this clinical opiate withdrawal scale to access – a Flowsheet for measuring symptoms over a period of time during buprenorphine induction.
Assessment Tools for Pain & Related Conditions Opioid-Specific Risk Assessments Screening Tools for Substance Use and Opioid Use Disorders
DIRE Score: Patient Selection for Chronic Opioid Analgesia
Use this brief tool to determine if a patient is a suitable candidate for long-term opioid analgesia.
Assessment Tools for Pain & Related Conditions Opioid-Specific Risk Assessments Screening Tools for Substance Use and Opioid Use Disorders Substance Use Disorder and Opioid Use Disorder Assessment Tools
Opioid Risk Tool
A brief, self-report screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse before and after patients are initiated on opioids for ...
Assessment Tools for Pain & Related Conditions Opioid-Specific Risk Assessments Screening Tools for Substance Use and Opioid Use Disorders
Risk Assessment: Safe Opioid Prescribing Tools
This site provides information on three types of risk assessments designed to detect different opioid-related dangers.
Assessment Tools for Pain & Related Conditions General Drug and Alcohol Risk Screening Tools Screening Tools for Substance Use and Opioid Use Disorders
NIDA: Tobacco, Alcohol, Prescription medications, and other Substance (TAPS) Tool
This instrument is used to assess primary care patients for tobacco, alcohol, prescription drug, and illicit substance use and problems related to their use, and is available for self-administration and ...
Assessment Tools for Pain & Related Conditions General Drug and Alcohol Risk Screening Tools Screening for Substance Misuse and Mental Health Conditions & Linkage to Services Screening Tools for Substance Use and Opioid Use Disorders Substance Use Disorder and Opioid Use Disorder Assessment Tools
DAST-10 (Drug Abuse Screen Test)
Access the DAST-10, a survey administered by the clinician or self-administered by the patient used to screen for drug abuse.
Assessment Tools for Pain & Related Conditions General Drug and Alcohol Risk Screening Tools Screening Tools for Substance Use and Opioid Use Disorders Substance Use Disorder and Opioid Use Disorder Assessment Tools
The AUDIT (Alcohol Use Disorder Identification Test)
Access the AUDIT, a simple, 10 question method of screening for excessive drinking and alcohol use disorders. Or use the AUDIT-C, a modified 3-item instrument.
Assessment Tools for Pain & Related Conditions Screening Tools for Evaluation of Acute and Chronic Pain
List of Clinically Tested and Validated Pain Scales
Access a list of the current clinically tested and validated scales used to assess pain in patients.