Pain Core Curriculum Module 12: Keys to Communication Success in Opioid Management-Presentation

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Video Summary

Dr. Erin Krebs, a general internal medicine physician, discusses effective communication strategies in managing long-term opioid therapy, emphasizing patient-centered care. She presents a typical case of a 50-year-old woman on high-dose opioids for chronic back pain with complex comorbidities. Rather than abruptly discontinuing opioids, Dr. Krebs advocates for shared decision-making—an iterative, collaborative process—to assess benefits, harms, and patient readiness for tapering.<br /><br />She highlights that long-term opioids often offer limited pain relief, carry increasing risks over time—including dependence, overdose, and functional impairment—and may worsen quality of life. Patients frequently want individualized attention and empathetic listening about their pain and quality of life rather than just medication management. Overdose risks may not be salient to patients, making open communication essential.<br /><br />Practical opioid tapering involves thorough assessment of pain impact, opioid benefits, side effects, and risk factors, followed by transparency in discussing concerns and careful planning. Tapering should be gradual, with close monitoring and patient input on pace and methods. Supporting patients through withdrawal symptoms and emphasizing improved function and well-being are key.<br /><br />Dr. Krebs concludes that successful opioid management requires respecting patient perspectives, prioritizing shared decisions, and building trust over time to safely reduce opioid use and improve overall patient outcomes.

Keywords

long-term opioid therapy

patient-centered care

shared decision-making

opioid tapering

chronic pain management

opioid dependence risks

communication strategies

functional improvement