title: Opioid therapy for chronic low back pain: prescribing considerations for advanced practice registered nurses.
abstract: Chronic low back pain is a common, disabling, and costly condition, and advanced practice registered nurses (APRNs) must carefully evaluate patients before considering long-term opioid therapy as a management strategy. APRNs should refer patients suspected of having a serious condition, or identifiable etiology, for specialist evaluation, as many patients improve with physical therapy, interventional pain management procedures, or surgical intervention. For patients unresponsive to nonopioid treatment, APRNs with an understanding of opioids, and the experience to assess and manage the risks of opioid misuse, abuse, and diversion, may consider long-term opioid therapy as part of a multimodal management plan. Such prescribing necessitates careful patient selection; informed consent; prudent opioid dosing and titration; and monitoring for response to treatment, adverse effects, and aberrant drug-taking behavior. Treatment and regulatory guidelines can assist APRNs in providing safe and effective care to patients with chronic low back pain.
authors.affiliation: Questions or comments about this article may be directed to Maureen Patricia Lall, MSN RN FNP-BC COHN-S, at maureenlall@gmail.com. She is a Neuroscience Program Coordinator at Houston Methodist Sugar Land Hospital, Sugar Land, TX, and a Doctoral Student at Texas Women's University.
authors.forename: Maureen Patricia
authors.initials: MP
authors.lastname: Lall
mesh_terms: D057179:Advanced Practice Nursing; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D019983:Guideline Adherence; D006801:Humans; D008134:Long-Term Care; D017116:Low Back Pain / Q000188:drug therapy* / Q000451:nursing*; D009726:Nurses; D009730:Nursing Assessment; D055553:Prescription Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs