VA/DoD Clinical Practice Guideline for the Use of Opioids in the Management of Chronic Pain - Version 4 - Update

Sep 25, 2026

Uploaded by awa

VA/DoD Clinical Practice Guideline for the Use of Opioids in the Management of Chronic Pain provides decision support for clinicians managing chronic pain with opioid therapy. Built on a systematic review of clinical and epidemiological evidence, it explains logical relationships between care options and outcomes while rating evidence quality and recommendation strength. The guideline emphasizes patient-centered application, acknowledges practice variation based on individual needs and institutional limitations, and clarifies it does not represent VA or TRICARE policy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages177

Reading Time7 h 26 min

AccessFree to download

Introduction

Background

Opioid Epidemic

Paradigm Shift in Pain and Its Treatment

Taxonomy and Pain Assessment

Epidemiology and Impact

Prioritizing Safe Opioid Prescribing Practices and Use

Scope of this Guideline

Guideline Audience

Guideline Population

Highlighted Features of this Guideline

Highlights in this Guideline Update

Components of the Guideline

Guideline Development Team

Summary of Guideline Development Methodology

Evidence Quality and Recommendation Strength

Implementation

VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE USE OF OPIOIDS IN THE MANAGEMENT OF CHRONIC PAIN Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard of care and should not be construed as one. Neither should they be interpreted as prescribing an exclusive course of management. This Clinical Practice Guideline is based on a systematic review of both clinical and epidemiological evidence. Developed by a panel of multidisciplinary experts, it provides a clear explanation of the logical relationships between various care options and health outcomes while rating both the quality of the evidence and the strength of the recommendation. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation with a patient-centered approach. These guidelines are not intended to represent Department of Veterans Affairs or TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within these guidelines does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found [at](at www.tricare. mil)[ ](at www.tricare. mil)[www.tricare. mil](at www.tricare. mil) by contacting your regional TRICARE Managed Care Support Contractor. Version 4.0 – 2022 Prepared by: Use of Opioids in the Management of Chronic Pain Work Group With support from: Office of Quality and Patient Safety, Veterans Health Administration & Clinical Quality Improvement Program, Defense Health Agency Version 4.0 – May 2022a Based on evidence reviewed through April 2021 a Suggested citation: VA/DoD Clinical Practice Guideline. (2022) . Use of Opioids in the Management of Chronic Pain Work Group. Washington, DC: U.S. Government Printing Office. Table of Contents I. Introduction..................................................................................................................................... 5 II. Background...................................................................................................................................... 5 A. Opioid Epidemic ................................................................................................................................... 5 B. Paradigm Shift in Pain and Its Treatment ........................................................................................... 7 C. Taxonomy and Pain Assessment ......................................................................................................... 8 D. Epidemiology and Impact .................................................................................................................. 10 a. General Population .................................................................................................................... 10 b. VA Population ............................................................................................................................ 11 c. DoD Population.......................................................................................................................... 12 E. Prioritizing Safe Opioid Prescribing Practices and Use ..................................................................... 13 III. Scope of this Guideline .................................................................................................................. 16 A. Guideline A

FAQs

What is the purpose of the VA/DoD opioid guideline?

It is designed to provide information and assist clinical decision-making for the management of chronic pain with opioids. It clarifies that it does not define a standard of care or constitute an exclusive approach.

How was the guideline developed?

It is based on a systematic review of clinical and epidemiological evidence. A multidisciplinary expert panel rated evidence quality and the strength of recommendations.

How should clinicians apply the guideline in practice?

Clinicians should evaluate whether applying the recommendations fits a specific patient-centered situation, considering individual patient needs, available resources, and institutional limitations.

Sep 25, 2026

Uploaded by awa