6. Skilled teaching and training

Deliver pain- and opioid-safety teaching to patient and caregiver competence with return demonstration:

• Safe opioid use, secure storage away from others, and proper disposal of unused medication.
• Naloxone — when and how to use it — with the caregiver return-demonstrating administration, and calling EMS immediately after.
• Recognizing over-sedation and slowed breathing as the warning signs that precede overdose, and to hold the next dose and seek help.
• The bowel regimen and the importance of preventing opioid-induced constipation, and reporting no bowel movement within the ordered interval.
• Non-pharmacologic pain strategies — positioning, heat or cold, pacing, and relaxation — as part of the plan.
• Avoiding alcohol and other sedating substances with opioids.
• When to call the agency versus when to give naloxone and activate EMS.