Adherence to prescribing guidelines for appropriate opioid dosing and duration can decrease the risk of opioid-related harm. In this retrospective analysis of nationally representative outpatient claims data, researchers found that over a 4-6 month period, 28% of Medicaid and 35% of privately-insured patients had at least one pain-related visit and 35% of all enrollees had one or more opioid prescriptions. Opioid prescribing rates varied depending on the specific medical indication and the patient’s opioid prescribing history. The researchers found that prescribing rates of many pain medical indications were not always aligned with current guidelines. For example, patients with chronic non-cancer pain conditions undergoing long-term opioid therapy were commonly prescribed daily doses above the threshold for which adverse events, such as overdose, are increased.

This Centers for Disease Control and Prevention report provides drug and opioid overdose death figures for 2016. The rate of overdose deaths continues to rise, with the largest increase due to synthetic opioids such as fentanyl. The report calls for enhancing prevention and response measures, including the use of naloxone.

The opioid epidemic continues unabated in the United States. Although efforts such as the 2016 Centers for Disease Control and Prevention guideline for opioid prescribing have raised awareness and changed practice, rates of opioid-related deaths are still rising. This study reports trends in emergency department visits for opioid overdose between July 2016 and September 2017. Researchers noted a nearly 30% increase in opioid overdose rates. Overdoses increased in all regions and most states, with the most prominent spikes noted in the West and Midwest. This sobering, high-quality, and timely data will inform initiatives to reduce high-risk prescribing, promote medication-assisted treatment, and improve secondary prevention of overdose. An Annual Perspective outlines strategies for mitigating opioid harms.

Opioids are high-risk medications and variation in prescribing practices is common. This retrospective pre–post intervention study describes a large health care system's initiative to improve opioid prescribing, patient monitoring, and care coordination for patients with chronic pain.

Opioid medications are frequently associated with adverse drug events in inpatient and outpatient settings. This surveillance report from the Centers for Disease Control and Prevention demonstrated that the magnitude of patient harm from opioid use is growing rapidly. Opioid overdose deaths are increasing each year, through 2015, and current rates are the highest ever recorded. The types of opioids most commonly involved in overdose deaths are natural and semisynthetic opioids, which are often prescribed as pain relievers. The authors suggest that the adoption of new prescribing guidelines and more widespread use of the opioid reversal agent naloxone will help address this growing epidemic. An earlier version of this article included data through 2014. A previous WebM&M commentary described a fatal opioid overdose.