High-risk opioid prescribing by providers contributes to opioid misuse. This systematic review sought to identify factors that confer risk for opioid addiction and thereby suggest which patients can safely take opioids. Researchers found that a prior history of substance use disorder, prescription of psychiatric medications, certain mental health diagnoses, higher daily opioid doses, and prescription of opioids for 30 days or more may confer risk for opioid addiction. The only factor associated with a lower risk of opioid use disorder was absence of a mood disorder. They could not identify any screening instruments or tools that accurately risk-stratified individuals' likelihood of opioid addiction. An Annual Perspective discussed problematic prescribing practices that likely contribute to adverse events and described promising practices to foster safer opioid use.

This study describes the Resident Site Visit Project (RSVP), which sent teams of internal medicine housestaff to other programs to learn about strategies for adopting duty hour regulations.