Figure 3.

Framework for empiric opioid dosing considerations, based on an adaptation of the “Opioid-naïve, -Exposed, or -Tolerant plus Modifiers” (O-NET+) stratification system for risk of postoperative opioid related adverse events in patients on preoperative opioid therapy [86]. Legend: Top pain describes the O-NET+ classification system based on prior opioid use and risk modifiers, and bottom pain describes a recommended risk-stratified approach to initial opioid dosing based on this classification system (see text and reference for further information). BTP = breakthrough pain, DOS = day of surgery, MED = morphine equivalent dose, PO = by mouth, PRN = as needed, SL = sublingual.