Activity 2: Managing the Chronic Pain Patient at Risk or with a History of Addiction

Two algorithms are referred to in this series. They were created by the Institute for Clinical Systems Improvement (ICSI) to accompany their guideline ‘Assessment and management of chronic pain.’ The algorithms are available from the ICSI website:

On the ICSI website you can also find these tools:

  • Brief pain inventory (short form)
  • Patient health questionnaire (PHQ-9)
  • Functional ability questionnaire
  • Personal care plan for chronic pain

Approved and Off-label medications for Chronic Pain: Download PDF

The first file contains a PDA version of the lecture notes for the material covered in the first six Learning Link activities.
Download Lecture Notes: Chronic pain-AAFP learning

The second file (OpCalc) is an equianalgesic opioid calculator. This PDA tool allows easy and accurate conversion when switching from one opioid medication to another opioid and uses standard equianalgesic dosing.
Download Opiate Calculator for Palm OS, Pocket PC (Windows Mobile) and PC Windows: OpCalc.prc

Installation Instructions
RediReader for Palm OS
RediReader for Pocket PC

Presentation Slides for Managing the Chronic Pain Patient at Risk or with a History of Addiction

Functional MRI: Gatchel RJ et al. Pain and the Brain. Practical Pain Management. 2008; 8(5):28-40

Toombs JD, Kral LA.
Methadone treatment for pain states. American Family Physician. 2005;71(7):1353-8:


Pomm HA, Pomm RM. Management of the Addicted Patient in Primary Care. NY: Springer Science, 2007.

Chronic Pain: A Primary Care Guide to Practical Management. Marcus DA. 1st Edition, HumanaPress, Totowa, NJ, 2005

Anxiety Screen: Download PDF
CAGE AID: Wisconsin Medical Journal 1995;94:135-140.
COMM tool:
Documentation Charting Sheets for Treatment of Chronic Pain: Download PDF
Drug Abuse Screening Test (DAST):
Methadone Fact Sheet: Download PDF
Opioid Risk Tool:
Pain Agreement: Download PDF
Pain Severity Assessment Tool: Download PDF
Pain Scale Comparison: Download PDF
Patient Health Questionnaire (PHQ): Download PDF
Release of Information Form: Download PDF

Pain Scales





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