Which statement best describes the steps required before prescribing opioid medications?

• A. Perform thorough evaluation of patient
• B. Check Prescription Monitoring Program
• C. Discuss risks and benefits of medication with patient
• D. All of the above steps and document all in medical records

Answer: (D)

Before prescribing opioid medications, you must go through a thorough, multi-part process that protects patient safety and meets regulatory expectations. Start with a comprehensive evaluation of the patient to establish the diagnosis, assess pain needs, review medical history, prior opioid exposure, risk factors for misuse, and alternatives to opioids. Next, check the Prescription Monitoring Program to uncover concurrent opioid or other controlled substance prescriptions, past dosing patterns, or red flags that might indicate misuse or dangerous interactions. Then, have an open discussion with the patient about the risks and benefits, realistic expectations, potential side effects, dependence, and non-opioid or non-pharmacologic options, ensuring informed consent. Finally, document all of these steps in the medical record. This complete, well-documented approach reflects standard of care, supports safe prescribing practices, and provides a solid record for regulatory and continuity purposes.