Non-Adherence to Treatment Plan

These algorithms suggest actions to implement when there are concerns that a patient on chronic opioids may be taking medications for symptoms other than pain and when they miss scheduled appointments with the opioid prescriber. 

The algorithms come from a Delphi study in which a panel of experts developed consensus over four rounds of structured discussion. The algorithms include Recommended actions, which had full consensus of the experts as items to implement, and Not Recommended actions, which had the full consensus of actions NOT to do.  The Consider items could be implemented, depending on the specifics of the situation.  

Both of these algorithms are clear that stopping opioids therapy is NOT the first action when addressing these issues. 
Taking opioids for symptoms other than pain
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Missing appointments
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Merlin JS, Young SR, Starrels JL, Azari S, Edelman EJ, Pomeranz J, Roy P, Saini S, Becker WC, Liebschutz JM. Managing Concerning Behaviors in Patients Prescribed Opioids for Chronic Pain: a Delphi study. J Gen Int Med, 2018 Feb:33(2):166-176.