Pain Medicine

Opioid dose conversion to morphine milligram equivalents (MME) is essential for safe prescribing, opioid rotation, and adherence to CDC prescribing guidelines. Total daily MME >50 mg/day is associated with a 2-fold increase in overdose risk, and >90 mg/day with a 4-9 fold increase, prompting recommendations for careful benefit-risk assessment at these thresholds.

Pain assessment using the Visual Analog Scale (VAS), Numeric Rating Scale (NRS), and Verbal Rating Scale (VRS) provides standardized, reproducible measurement of pain intensity. The Brief Pain Inventory (BPI) and McGill Pain Questionnaire (MPQ) offer multidimensional pain assessment including interference with daily function.

Chronic opioid therapy risk screening tools include the Opioid Risk Tool (ORT), which stratifies patients into low, moderate, and high risk for aberrant opioid-related behaviors based on personal and family history of substance use, age, and psychological comorbidities. The SOAPP-R and COMM tools provide ongoing monitoring of aberrant behaviors during therapy.