About the SEMP Guidelines

Chronic pain affects more than one in five U.S. adults1 and has an estimated economic impact of $560–$635 billion each year.2 When not effectively treated, pain can negatively affect physical, emotional, and social well-being. At the same time, West Virginia has faced some of the nation’s highest rates of opioid-related harm, with overdose deaths continuing to be a significant public health concern.3

To address these challenges, a professionally diverse panel of West Virginia pain management experts developed the Safe & Effective Management of Pain (SEMP) Guidelines in 2016. These guidelines were designed to build upon the CDC’s Guideline for Prescribing Opioids for Chronic Pain — United States, 2016, by addressing not only opioid prescribing but also the safe and effective use of all pain treatments, along with practical risk reduction strategies. Following the release of the CDC’s Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022, a new task force was convened to revise and expand the SEMP Guidelines, ensuring they remain practical, evidence-based, and responsive to the ongoing challenges of pain care.

The SEMP Guidelines are intended to serve solely as a resource for clinicians by outlining evidence-informed strategies that may help reduce risk and improve patient safety in pain management. They are not a standard of care, but rather a reference to support providers as approaches to chronic pain continue to evolve. The guidelines emphasize two key components:

Risk Reduction Strategies

A central goal of the SEMP Guidelines is to minimize patient risk and reduce provider anxiety in the treatment of chronic pain. Historically, pain management strategies relied heavily on subjective measures rather than objective assessments. The guidelines outline a variety of practical, evidence-informed risk reduction strategies designed to improve patient safety, reduce harm, and support more effective clinical decision-making.

Clinical Treatment Algorithms

The guidelines also introduce safe and effective treatment algorithms based on best practices, clinical experience, and published evidence. These algorithms address the three main classifications of pain: nociceptive, neuropathic, and mixed. They are similar in concept to clinical pathways for managing conditions such as hypertension or diabetes. The algorithms are designed to help clinicians balance effective pain control with patient safety, while recognizing that each case is unique and requires individualized clinical judgment.

References

  1. Rikard S, Strahan A, Schmit K, Guy Jr J. Chronic Pain Among Adults. MMWR Morb Mortal Wkly Rep. 2023;72:379-385. ↩︎
  2. Gaskin D, Richard P. The economic costs of pain in the United States. J Pain. 2012;13(8):715-724. ↩︎
  3. Garnett M, Minino A. Changes in drug overdose mortality and selected drug type by state: United States, 2022 to 2023. NCHS Health E-stats. 2025. ↩︎