Clinical Support, Tools, and Guidelines
The CIAO team has collated these resources to support academic detailers, primary care providers, and anyone else involved in the care of patients with chronic pain and who use opioids. We hope this page will serve as a resource to find helpful clinical documentation, guidance, and tools to support clinical decision making and patient care regarding opioid and chronic pain management.
Clinical Support for Providers
UCSF Substance Use Warmline: Free, confidential, peer-to-peer consultation from physicians, clinical pharmacists, and nurses with expertise in substance use evaluation and management for clinicians across the nation.
Monday – Friday, 9 a.m. – 8 p.m. ET
California Substance Use Line: Staffed by experienced physicians and pharmacists who can answer confidential questions about substance use evaluation and management, including medications to treat opioid use disorder, the California Substance Use Line provides fast, reliable, patient-tailored guidance and resources to facilitate substance use prevention and treatment efforts for California-based clinicians.
Open 24 hrs a day, 7 days a week
California Bridge: Develops hospitals and emergency rooms into primary access points for substance use disorder treatment. The program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.
Resources page: CA Bridge lists a variety of resources related to substance use management, treatment, and care. Resources are included for clinicians, patients, and substance use navigators.
A patient-centered, rapid access approach to substance use disorders: Recommendations to help clinicians provide rapid, low-threshold, and patient-centered substance use disorder treatment.
Clinical Tools for Providers (Opioid management, Tapering, and MOUD)
Pain, Enjoyment, General activity (PEG) scale (pdf): A simple 3-question tool for addressing pain intensity and interference.
Clinical Opioid Withdrawal Scale (COWS) (pdf): 11-item scale administered by a clinician to determine the stage and severity of opiate withdrawal.
Opioid risk tool: A brief, self-report screening tool designed to assess the risk of developing an opioid use disorder among patients being considered for or already receiving a prescription opioid for pain relief in primary care settings.
CDC Opioid Overdose Clinical Tools for Primary Care Providers: A set of clinical tools from the CDC to help primary care providers carry out the complex task of balancing pain management with the potential risks that prescription opioids pose.
Working With HIV Clinics to Adopt Addiction Treatments Using Implementation Facilitation (WHAT-IF?) Toolkit: Resources and websites for any HIV or primary care clinic seeking to integrate treatments for Tobacco, Alcohol, Opioid, and other substance use disorders into their clinical practice and care models.
MME Conversion Table: Tool for calculating milligram morphine equivalents (MME) for opioids.
Transforming Opioid Prescribing in Primary Care (myTOPCARE): Resources for a novel system change in delivery of primary care services to decrease prescription opioid misuse for patients with chronic pain.
Resources for prescribers for assessing risk and starting, continuing, and stopping opioids.
Illicit Screening Test Cross-Reference Table for urine drug screening interpretation.
Veteran's Health Administration: Opioid taper decision tool (pdf): Designed to assist primary care providers in determining if an opioid taper is necessary, in performing the taper, and in providing follow-up and support during the taper.
Medications of Opioid Use Disorder
Buprenorphine home induction guides:
X-waiver: complete and submit an online buprenorphine waiver notification form here.
For more information, contact SAMHSA:
(866) BUP-CSAT (866-287-2728)
DEA: Electronic Prescribing of Controlled Substance (EPCS): (located in the middle of the page).
Information and support on medications during pregnancy and breastfeeding: Includes important resources pertaining to opioid use during pregnancy and while breastfeeding, including links to our evidence-based Fact Sheets.
Opioid Stewardship (documentation suggestions, Controlled Substance Agreements, CSMP/PDMP information, etc.)
Opioids for Chronic Pain Documentation Suggestions: A template and example of a medical chart for a clinician documenting their decision-making rationale when treating patients with chronic pain and who use opioids.
Controlled substance agreement templates
Drugabuse.gov: includes two sample patient agreement forms that can be used with patients who are beginning long-term treatment with opioid analgesics or other controlled substances.
Controlled Substance Monitoring Programs (CSMP/PDMP)
Prescription Drug Monitoring Training and Technical Assistance Center: A comprehensive array of services, support, resources, and strategies to PDMPs, federal partners and other stakeholders to further the efforts and effectiveness of PDMPs.