The Dueling Obligations of Opioid Stewardship
Authors: Phillip Coffin, Caleb Banta-Green
Journal: Annals of Internal Medicine (2013)

Editorials4 February 2014The Dueling Obligations of Opioid StewardshipPhillip Coffin, MD, MIA and Caleb Banta-Green, PhDPhillip Coffin, MD, MIAFrom San Francisco Department of Public Health, San Francisco, California; and University of Washington, Seattle, Washington. and Caleb Banta-Green, PhDFrom San Francisco Department of Public Health, San Francisco, California; and University of Washington, Seattle, Washington.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2781 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The United States leads the developed world in drug poisonings, a title earned through vastly increased opioid analgesic use (1). Overdoses involving opioid analgesics killed almost 17 000 persons in 2010—nearly as many as car accidents—and the number of people with opioid analgesic use disorders has increased to nearly 2 million. As a medical community, we have an ethical obligation to use our resources not only to reduce the incidence of opioid use disorders but also to provide optimum care to patients who have developed disorders due, at least in part, to our prescribing practices. Equally important, medical organizations have an ...References1. US Burden of Disease Collaborators. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310:591-608. [PMID: 23842577] CrossrefMedlineGoogle Scholar2. Kirschner N, Ginsburg J, Snyder Sulmasy L. Prescription drug abuse: executive summary of a policy position paper from the American College of Physicians. Ann Intern Med. 2014;160:198-200. LinkGoogle Scholar3. Institute of Medicine (US) Committee on Advancing Pain Research Care and Education. Institute of Medicine (US) Committee on Advancing Pain Research Care and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. 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Presented at the College on Problems of Drug Dependence Annual Meeting, 9–14 June 2012, Palm Springs, CA. Google Scholar9. Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC. Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database Syst Rev. 2013;8:CD004959. [PMID: 23983011] MedlineGoogle Scholar10. Roux P, Sullivan MA, Cohen J, Fugon L, Jones JD, Vosburg SK, et al. Buprenorphine/naloxone as a promising therapeutic option for opioid abusing patients with chronic pain: reduction of pain, opioid withdrawal symptoms, and abuse liability of oral oxycodone. Pain. 2013;154:1442-8. [PMID: 23707283] CrossrefMedlineGoogle Scholar11. Walley AY, Xuan Z, Hackman HH, Quinn E, Doe-Simkins M, Sorensen-Alawad A, et al. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346:f174. [PMID: 23372174] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From San Francisco Department of Public Health, San Francisco, California; and University of Washington, Seattle, Washington.Disclaimer: The authors are solely responsible for the content of this article, which does not necessarily represent the official views of the San Francisco Department of Public Health.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2781.Corresponding Author: Phillip Coffin, MD, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102; e-mail, [email protected]com.Current Author Addresses: Dr. Coffin: San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102.Dr. Banta-Green: Alcohol and Drug Abuse Institute, University of Washington, 1107 Northeast 45th Street, Suite 120, Box 354805, Seattle, WA 98105-4631.This article was published online first at www.annals.org on 10 December 2013. 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Walden Retan, MDThe Dueling Obligations of Opioid StewardshipWilliam M. Tierney, MD 4 February 2014Volume 160, Issue 3Page: 207-208KeywordsAnalgesicsDrugsOpioidsPain managementPatientsPrevention, policy, and public healthSurgeonsVital signs ePublished: 4 February 2014 Issue Published: 4 February 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...