{description: 'Recommendation 4: When opioids are initiated for opioid-naïve patients with acute, subacute, or chronic pain, clinicians should prescribe the lowest effective dosage. If opioids are continued for subacute or chronic pain, clinicians should use caution when prescribing opioids at any dosage, should carefully evaluate individual benefits and risks when considering increasing dosage, and should avoid increasing dosage above levels likely to yield diminishing returns in benefits relative to risks to patients. Recommendation 5: For patients already receiving opioid therapy, clinicians should carefully weigh benefits and risks and exercise care when changing opioid dosage. If benefits outweigh risks of continued opioid therapy, clinicians should work closely with patients to optimize nonopioid therapies while continuing opioid therapy. If benefits do not outweigh risks of continued opioid therapy, clinicians should optimize other therapies and work closely with patients to gradually taper to lower dosages or, if warranted based on the individual circumstances of the patient, appropriately taper and discontinue opioids. Unless there are indications of a life-threatening issue such as warning signs of impending overdose (e.g., confusion, sedation, or slurred speech), opioid therapy should not be discontinued abruptly, and clinicians should not rapidly reduce opioid dosages from higher dosages.', package_name: fhir.cdc.opioid-cds, name: PlanDefinition_Recommendation_04_05_Order_Sign, type: '{:coding [{:system \"http://terminology.hl7.org/CodeSystem/plan-definition-type\", :code \"eca-rule\", :display \"ECA Rule\"}]}', package_version: 2022.1.1, class: unknown, kind: null, url: 'http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-04-05', version: 2022.1.0}