In 2016, the Centers for Disease Control and Prevention (CDC) released guidelines for safe opioid prescribing for chronic pain. Based on an updated evidence review, the CDC has revised the guidelines and released the Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022, include recommendations for outpatient acute, subacute, and chronic opioid use. The twelve recommendations fall into four broad categories: determining whether or not to initiate opioids for pain; selecting opioids and determining opioid dosages; deciding duration of initial opioid prescription and conducting follow-up; and assessing risk and addressing potential harms of opioid use. The CDC will update and develop tools and resources to support dissemination of these guidelines. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care, or for patients in the emergency department or admitted to the hospital.

Patients prescribed high doses of opioids for acute pain are at increased risk of developing long-term dependence. Researchers implemented a 15-pill default dose for Schedule II opioids in two emergency rooms. This initiative was feasible, not bothersome, and reduced high-dose prescriptions at one hospital. An Annual Perspective described other initiatives to reduce opioid-related harm.

The opioid crisis presents challenges to a wide range of health care professionals. This commentary highlights unique contributions pharmacists can offer to stemming prescription opioid misuse, such as utilizing prescription monitoring tools to help identify problematic behaviors in patients and prescribers, informing patients about risks of opioid use, and recommending addiction treatment for patients at the community level.

… the patient safety aspects of the opioid epidemic. … Han B, Compton WM, Blanco C, Crane E, Lee J, Jones CM. Prescription Opioid Use, …

Improving the safety associated with opioid use is a major health policy priority. Investigators found that drug scheduling changes imposed by the US Drug Enforcement Administration (including tighter prescribing standards and prohibiting refills) led to major reductions in the prescribing and dispensing of hydrocodone combination analgesic products.