Question

A 46-year-old man with chronic low back pain on long-term oxycodone attends your family practice. He is on 120 mg oral morphine equivalent daily dose, with limited functional improvement and multiple early refill requests. According to the 2017 Canadian guideline for opioid therapy for chronic non-cancer pain, what is the most appropriate approach?

Accepted Answer

Initiate a gradual taper of opioids while optimising non-opioid and non-pharmacologic therapies

Answer

Increase the opioid dose further to achieve complete pain relief

Answer

Continue the current opioid dose indefinitely as long as he requests it

Answer

Switch immediately to long-acting hydromorphone at an equianalgesic or higher dose without reassessment

Answer

Abruptly discontinue all opioids without discussion or support

Practice question