Managing Acute Pain in the Hospital in the Face of the Opioid Crisis
Authors: Shoshana J. Herzig
Journal: Annals of Internal Medicine (2019)

Letters7 May 2019Managing Acute Pain in the Hospital in the Face of the Opioid CrisisShoshana J. Herzig, MD, MPHShoshana J. Herzig, MD, MPHBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (S.J.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0052 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Ti and Nolan note that hospitals are consistently overlooked as a setting that both substantially contributes to the opioid crisis in North America and is ripe for effective interventions to curb this epidemic. Changing the culture around pain treatment requires interventions that address physician prescribing and patient expectations. I agree that systems-based interventions will probably be more successful at changing physician prescribing practices than physician education, but both are necessary.As Drs. Ti and Nolan state, several hospitals have adapted and applied the concept of antimicrobial stewardship to opioid prescribing by forming OSPs (1, 2). They also ...References1. Ghafoor VL, Phelps P, Pastor J. Implementation of a pain medication stewardship program. Am J Health Syst Pharm. 2013;70:2070, 2074-5. [PMID: 24249754] doi:10.2146/ajhp120751 CrossrefMedlineGoogle Scholar2. Weiner SG, Price CN, Atalay AJ, Harry EM, Pabo EA, Patel R, et al. A health system-wide initiative to decrease opioid-related morbidity and mortality. Jt Comm J Qual Patient Saf. 2019;45:3-13. [PMID: 30166254] doi:10.1016/j.jcjq.2018.07.003 CrossrefMedlineGoogle Scholar3. Homsted FAE, Magee CE, Nesin N. Population health management in a small health system: impact of controlled substance stewardship in a patient-centered medical home. Am J Health Syst Pharm. 2017;74:1468-75. [PMID: 28887348] doi:10.2146/ajhp161032 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (S.J.H.)Disclaimer: The funding agency had no involvement in any aspect of this comment. The content is solely the responsibility of the author and does not necessarily represent the official policy or position of the Beth Israel Deaconess Medical Center, Harvard Medical School, or the National Institute on Aging.Grant Support: Dr. Herzig is funded by grant number K23AG042459 from the National Institute on Aging.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2295. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists Inpatient Notes - Managing Acute Pain in the Hospital in the Face of the Opioid Crisis Shoshana J. Herzig Managing Acute Pain in the Hospital in the Face of the Opioid Crisis Lianping Ti and Seonaid Nolan Metrics 7 May 2019Volume 170, Issue 9Page: 666KeywordsAgingAntimicrobialsClinical decision support systemsDisclosureInformation technologyMotivationOpioidsOutpatients ePublished: 7 May 2019 Issue Published: 7 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...