Guidelines for Opioid Prescription: The Devil Is in the Details
Authors: Alex M Rosenau
Journal: Annals of Internal Medicine (2013)

In the Balance4 June 2013Guidelines for Opioid Prescription: The Devil Is in the DetailsAlex M. Rosenau, DOAlex M. Rosenau, DOFrom Lehigh Valley Health Network, Allentown, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-11-201306040-00632 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail More people in the United States now die of prescription drug overdose than accidental vehicular trauma (1). This startling statistic has stimulated physicians, government agencies, and various organizations to effect change through provider guidelines, patient education, and proactive legislation. Opioid analgesics, particularly oxycodone, are major contributors to this trend in preventable death.Elected officials often erroneously point to the emergency department (ED) as a leading source of opioid prescriptions. In addition, legislative and regulatory action across the United States has called for mandatory continuing education and reclassification of hydrocodone to a schedule II drug. The mayor of New York City ...References1. Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980–2008. NCHS Data Brief. 2011;:1-8. [PMID: 22617462] MedlineGoogle Scholar2. Chu J, Farmer B, Ginsburg BY, Hernandez SH, Kenny JF, Majlesi N, et al; New York City Emergency Department Discharge Opioid Prescribing Guidelines Clinical Advisory Group. New York City Emergency Department Discharge Opioid Prescribing Guidelines. Queens, NY: New York City Department of Health and Mental Hygiene; 2013. Accessed at www.nyc.gov/html/doh/html/mental/drug-opioid-guidelines.shtml on 28 February 2013. Google Scholar3. Governale L. Outpatient Prescription Opioid Utilization in the U.S., Years 2000–2009. Presented at the Joint Meeting of the Anesthetic and Life Support Advisory Committee and the Drug Safety and Risk Management Advisory Committee, Adelphi, Maryland, 22–23 July 2010. Accessed at www.fda.gov/downloads/AdvisoryCommitteesMeetingMaterials/Drugs/AnestheticAndLifeSupportDrugsAdvisoryCommittee/UCM220950.pdf (slide 16) on 28 February 2013. Google Scholar4. Benard A. Prescription Drug Abuse: Florida's Health Crisis. Presented at the American Medical Association State Legislative Strategy Conference, Aventura, Florida, 3–5 January 2013. Accessed at www.ama-assn.org/resources/doc/arc/no-index/2013-01-04-drug-diversion-abuse-benard.pdf on 19 March 2013. Google Scholar5. American College of Emergency Physicians. Policy Compendium: Electronic Prescription Monitoring. 2013. Accessed at www.acep.org/policystatements on 12 February 2013. Google Scholar6. American College of Emergency Physicians. Policy Compendium: Emergency Physician Rights and Responsibilities. 2013. Accessed at www.acep.org/policystatements on 12 February 2013. Google Scholar7. Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers—-United States, 1999—2008. MMWR Morb Mortal Wkly Rep. 2011;60:1487-92. [PMID: 22048730] MedlineGoogle Scholar8. Cantrill SV, Brown MD, Carlisle RJ, Delaney KA, Hays DP, Nelson LS, et al; American College of Emergency Physicians Opioid Guideline Writing Panel. Clinical policy: critical issues in the prescribing of opioids for adult patients in the emergency department. Ann Emerg Med. 2012;60:499-525. [PMID: 23010181] CrossrefMedlineGoogle Scholar9. American College of Emergency Physicians. Policy Compendium: Optimizing the Treatment of Pain in Patients with Acute Presentations. 2013. Accessed at www.acep.org/policystatements on 12 February 2013. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Lehigh Valley Health Network, Allentown, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0376.Corresponding Author: Alex M. Rosenau, DO, Lehigh Valley Health Network, JDMCC 214, I-78 and Cedar Crest Boulevard, Allentown, PA 18103; e-mail, alex.[email protected]com.Author Contributions: Conception and design: A.M. Rosenau.Analysis and interpretation of the data: A.M. Rosenau.Drafting of the article: A.M. Rosenau.Critical revision of the article for important intellectual content: A.M. Rosenau.Final approval of the article: A.M. Rosenau.Collection and assembly of data: A.M. Rosenau.This article was published at www.annals.org on 9 April 2013. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGuidelines for Opioid Prescription: Why Emergency Physicians Need Support Hillary V. Kunins , Thomas A. Farley , and Deborah Dowell Metrics Cited ByEmergency Department Contribution to the Prescription Opioid EpidemicBarriers to access to opioid medicines: a review of national legislation and regulations of 11 central and eastern European countriesHow Do Physicians Adopt and Apply Opioid Prescription Guidelines in the Emergency Department? A Qualitative StudyAbusive Prescribing of Controlled Substances — A Pharmacy View 4 June 2013Volume 158, Issue 11Page: 843-844KeywordsAnalgesicsArthralgiaDrug administrationDrugsOpiatesOpioidsOutpatientsPatientsPsychiatry and mental health ePublished: 4 June 2013 Issue Published: 4 June 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...