Care Management for the Effective Use of Opioids

"During the baseline assessment, the nurse care managers will determine current and past treatments for chronic lower back pain and establish whether or not patients have had an adequate trial (i.e., were analgesics sufficiently dosed). If not, the nurse care manager in conjunction with study doctors will recommend an adjustment of the patients' opioid or initiate treatment with a co-analgesic with appropriate dosing and scheduling.~The Patients in the MED arm will be asked to sign an opioid treatment agreement at enrollment."

There will be 8 sessions of pain self-management and coping skills.