Level C recommendations: Research evidence to support superior pain relief for short-acting schedule II over schedule III opioids is inadequate.
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ACEP News: Vol 31 – No 08 – August 20124. In the adult ED patient with an acute exacerbation of noncancer chronic pain, do the benefits of prescribing opioids on discharge from the ED outweigh the potential harms?
Recommendations:
Level A recommendations: None specified.
Level B recommendations: None specified.
Level C recommendations: (1) Physicians should avoid the routine prescribing of outpatient opioids for a patient with an acute exacerbation of chronic noncancer pain seen in the ED. (2) If opioids are prescribed on discharge, the prescription should be for the lowest practical dose for a limited duration (e.g., <1 week), and the prescriber should consider the patient’s risk for opioid misuse, abuse, or diversion. (3) The clinician should, if practicable, honor existing patient-physician pain contracts/treatment agreements and consider past prescription patterns from information sources such as prescription drug monitoring programs.
To view ACEP’s entire Opioid Clinical Policy, go to www.acep.org/clinicalpolicies.
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