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When patients have not made adequate progress toward achieving treatment goals through nonpharmacologic and nonopioid treatment, physicians may consider a trial of opioid therapy. However, problematic behaviors, including diversion and addiction can overshadow the positive role opioids can play for some patients who have chronic pain. Family physicians may be reluctant to open themselves and their practices up to the kind of problems that may be associated with opioid prescribing. This monograph offers advice for how to balance patient needs with these concerns and ensure that patients who have chronic pain are treated appropriately.
