When we decide to prescribe a medication we refer to the following guidelines:

 WHO Ladder   is a way of reminding us to start with the least invasive medications before increasing to stronger medications that may carry more risk.

 National Opioid Use Guidelines  is a tool in chronic pain management to help develop a safe way of using this class of medication.

Decision to Prescribe
  • Assessment (RO1)

  • Addiction Screening (RO2)

  • UDT (RO3)

  • Efficiency (RO4)

  • Adverse Effects (RO5)

  • Benzodiazepine Taper (RO6)

Trial of Opioid
  • Consent and Agreement (RO5)

  • Driving (RO7)

  • Stepped WHO Ladder (RO8)

  • Optimal Dose (RO9)

  • Watchful Dose (RO10)

  • Risk (RO11)

Monitoring of LTOT
  • Effectiveness (6 A's) (R12)

  • Opioid Rotation (R13)

  • Driving (R14)

  • Revisit (RO15)

  • Collaborative Care (RO16)

Specific Population
  • Elderly (R17)

  • Adolescent (R18)

  • Pregnant (R19)

  • Psychiatric (RO20)

Managing Misuse & Addiction
  • Addiction Options (R21)

  • Fraud (R22)

  • Unacceptable Patient Behaviour (R23)

  • Policy (R24)

 Neuropathic Pain Guidelines  it is our belief that most if not all chronic pain patients have some neuropathic component. These guidelines start with medications that have the most literature to support their use.

Fax: (613) 344-1203

800 John Marks Avenue

800 John Marks Ave  
Kingston, ON  K7K 0J7
PHONE: (613) 507-7246
FAX: (613) 344-1203
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