New York City Opioid Prescribing Guidelines
EMERGENCY MEDICINE, SUBSTANCE ABUSE
Guidelines developed by a NYC task force, which were designed to reduce the number of opioids prescribed for patients with acute or chronic noncancer pain discharged from emergency departments, based on 9 points of consideration.
New York City opioid prescribing guidelines
• Consider short-acting opioid analgesics for treating acute pain only when the severity of the pain is reasonably assumed to warrant their use.
• Begin with the lowest possible effective dose if opioid analgesics are considered for managing the pain
• Prescribe a short–ideally 3 days or less–course of opioid analgesics for acute pain
• To assess for opioid misuse or addiction, use targeted history or validated screening tools and, if needed, access the New York State Controlled Substance Information (CSI) on Dispensed Prescriptions Program for information on patients’ controlled substance prescription history.
• Avoid initiating treatment with long-acting or extended-release opioid analgesics.
• Address exacerbations of chronic or recurrent pain conditions with nonopioids, nonpharmacological therapies, and/or referral to specialists for follow-up, all as clinically appropriate.
• Avoid prescribing opioid analgesics to patients taking benzodiazepines and/or other opioids. Weigh other risk factors for consequential respiratory depression.
• Attempt to confirm with the treating physician the validity of patient allegations of lost, stolen, or destroyed prescriptions. Try to limit prescription to 1-2-day supply.
• Provide patients with information about opioid analgesics–e.g., risks of overdose and dependence/addiction, as well as safe storage and proper disposal of unused medications.
Synonyms New York City Emergency Department Discharge Opioid Prescribing Guidelines
JAMA 2013; 309:879-880