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A perspective on opioid prescribing strategies to combat the opioid epidemic has been recently published New England Journal of Medicine.[1]
Nearly half of US states have limits on the amount of opioids that can be prescribed for acute pain. Some states specify the number of days that can be prescribed or set a maximum dose that can be delivered. Although there is no national standard for the duration and dosage of an opioid in a patient with a recent temporary disorder of good faith, a national standard for such limitations has been proposed. However, these limitations would not be applicable to patients with chronic pain or cancer, or those who are already dependent.[1]
So, what is the probability that a patient who receives an opioid for transient pain becomes dependent? Among new users of opioids, about 6% continued to use opioids at one year.[2] In addition, "the chances of chronic use begin to increase after the third day provided".[2]
Interestingly, a study showed that a large percentage of people who use opioids inappropriately receive them from friends or relatives, bypassing doctors.[3]
The authors of this perspective suggest that there is a need for "strategies to encourage the use of non-opioid alternatives, stopping opioids after episodes of acute pain and loneliness." elimination of the remaining pills ".[1]
They also formulated the recommendation that "a three-day supply will be sufficient for most opioid prescriptions for acute pain," but add that a three-day limit may be too much restrictive for the most severe indications.[1]
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Medscape Pulmonary Medicine © 2018 WebMD, LLC
All opinions expressed above are those of the author and do not necessarily reflect the views of WebMD or Medscape.
Quote this article: Nicholas Gross. Prescription of opioids for acute pain: bring it to the limit – Medscape – September 26, 2018.
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