Quality Standard Details
Opioid Prescribing for Acute Pain: Care for People 15 Years of Age and Older
- Publication Date
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2018-March-01
- Status
- Published
- Topic Area
- Pain
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Acute pain is typically a normal, predicted response to surgery, acute illness, trauma, or other injury. Acute pain is best treated through a multimodal approach that combines different pharmacological and nonpharmacological therapies. Opioid therapy is one treatment option within this approach, and one that is commonly used. However, opioids are often prescribed for acute pain conditions when non-opioid treatments would be similarly effective.
There are also troubling variations across Ontario in how opioids are prescribed for acute pain; for example, there are variations in the daily dose of opioids prescribed, with 21% to 42% of new opioid prescriptions from surgeons in Ontario exceeding the recommended dose of 50 mg morphine equivalents.
The potential benefits of opioid therapy for acute pain are short-term pain control and a quicker return to normal function. The potential harms include the risks of long-term use, addiction, overdose, and death.
This quality standard provides guidance on the appropriate prescribing, monitoring, and tapering of opioids to treat acute pain for people 15 years of age and older in all care settings. It does not address opioid prescribing for chronic pain or end-of-life care, nor does it address the management of opioid use disorder in depth.
Please refer to Ontario Health’s Opioid Prescribing for Chronic Pain quality standard and Opioid Use Disorder quality standard for detailed quality statements related to these topics.
Quality Standard in Brief
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Quality Statement 1: Comprehensive Assessment
People with acute pain receive a comprehensive assessment to guide pain management.
Quality Statement 2: Multimodal Therapies
People with acute pain receive multimodal therapy consisting of non-opioid pharmacotherapy with physical and/or psychological interventions, with opioids added only when appropriate.
Quality Statement 3: Opioid Dose and Duration
People with acute pain who are prescribed opioids receive the lowest effective dose of the least potent immediate-release opioid. A duration of 3 days or less is often sufficient. A duration of more than 7 days is rarely indicated.
Quality Statement 4: Information on Benefits and Harms of Opioid Use and Shared Decision-Making
People with acute pain and their families and caregivers receive information about the potential benefits and harms of opioid therapy, safe storage, and safe disposal of unused medication at the times of both prescribing and dispensing.
Quality Statement 5: Acute Pain in People Who Regularly Take Opioids
People with acute pain who regularly take opioids receive care from a health care professional or team with expertise in pain management. Any short-term increase in opioids to treat acute pain is accompanied by a plan to taper to the previous dose.
Quality Statement 6: Acute Pain in People With Opioid Use Disorder
People taking buprenorphine/naloxone or methadone for the treatment of opioid use disorder continue their medication during acute-pain events.
Quality Statement 7: Prescription Monitoring Systems
Health care professionals who prescribe or dispense opioids have access to a real-time prescription monitoring system at the point of care. Prescription history is checked when opioids are prescribed and dispensed to avoid duplicate prescriptions, potentially harmful medication interactions, and diversion.
Quality Statement 8: Tapering and Discontinuation
People prescribed opioids for acute pain are aware of the potential for experiencing physical dependence and symptoms of withdrawal and have a plan for tapering and discontinuation.
Quality Statement 9: Health Care Professional Education
Health care professionals have the knowledge and skills to appropriately assess and treat acute pain using a multimodal approach; appropriately prescribe, monitor, taper, and discontinue opioids; and recognize and treat opioid use disorder.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard
- Tools to support patient care
- Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
