Guidelines for Opioid Prescription: Why Emergency Physicians Need Support

In the Balance4 June 2013Guidelines for Opioid Prescription: Why Emergency Physicians Need SupportHillary V. Kunins, MD, MPH, MS, Thomas A. Farley, MD, MPH, and Deborah Dowell, MD, MPHHillary V. Kunins, MD, MPH, MSFrom the New York City Department of Health and Mental Hygiene, Queens, New York.Search for more papers by this author, Thomas A. Farley, MD, MPHFrom the New York City Department of Health and Mental Hygiene, Queens, New York.Search for more papers by this author, and Deborah Dowell, MD, MPHFrom the New York City Department of Health and Mental Hygiene, Queens, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-11-201306040-00631 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail On 10 January 2013, The New York Times reported that new guidelines would “sharply” restrict opioid analgesic prescription at New York City hospitals. That phrase is a great exaggeration of their power, as the New York City Emergency Department (ED) Discharge Opioid Prescribing Guidelines (1) are voluntary guidelines crafted by practicing emergency physicians and the New York City Department of Health and Mental Hygiene. Still, they were announced by Mayor Michael Bloomberg, which is distinctly unusual for a release of clinical guidelines. Why did emergency physicians, who are already able to prescribe opioids (or not), regardless of government backup, welcome ...References1. Chu J, Farmer B, Ginsburg BY, Hernandez SH, Kenny JF, Majlesi N, et al; New York City Emergency Department Discharge Opioid Prescribing Guidelines Clinical Advisory Group. New York City Emergency Department Discharge Opioid Prescribing Guidelines. Queens, NY: New York City Department of Health and Mental Hygiene; 2013. Accessed at www.nyc.gov/html/doh/html/mental/drug-opioid-guidelines.shtml on 20 March 2013. Google Scholar2. Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980–2008. NCHS Data Brief. 2011;:1-8. PMID: 22617462 MedlineGoogle Scholar3. Centers for Disease Control and Prevention (CDC). 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Boscarino JA, Rukstalis MR, Hoffman SN, Han JJ, Erlich PM, Ross S, et al. Prevalence of prescription opioid-use disorder among chronic pain patients: comparison of the DSM-5 vs. DSM-4 diagnostic criteria. J Addict Dis. 2011;30:185-94. PMID: 21745041 CrossrefMedlineGoogle Scholar9. Franklin GM, Stover BD, Turner JA, Fulton-Kehoe D, Wickizer TM; Disability Risk Identification Study Cohort. Early opioid prescription and subsequent disability among workers with back injuries: the Disability Risk Identification Study Cohort. Spine (Phila Pa 1976). 2008;33:199-204. PMID: 18197107 CrossrefMedlineGoogle Scholar10. Bohnert AS, Valenstein M, Bair MJ, Ganoczy D, McCarthy JF, Ilgen MA, et al. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011;305:1315-21. PMID: 21467284 CrossrefMedlineGoogle Scholar11. Paone D, Dowell D, Heller D. Preventing misuse of prescription opioid drugs. City Health Information. 2001;30:23-30. Accessed at www.nyc.gov/html/doh/downloads/pdf/chi/chi30-4.pdf on 13 February 2013. Google Scholar Author, Article, and Disclosure InformationAffiliations: From the New York City Department of Health and Mental Hygiene, Queens, New York.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0412.Corresponding Author: Hillary V. Kunins, MD, MPH, MS, New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Queens, NY 11101.Current Author Addresses: Drs. Kunins, Farley, and Dowell: New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Queens, NY 11101.Author Contributions: Conception and design: H.V. Kunins, T.A. Farley, D. Dowell.Drafting of the article: H.V. Kunins, T.A. Farley, D. Dowell.Critical revision of the article for important intellectual content: H.V. Kunins, T.A. Farley, D. Dowell.Final approval of the article: H.V. Kunins, T.A. Farley, D. Dowell.Collection and assembly of data: H.V. Kunins.This article was published at www.annals.org on 9 April 2013. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGuidelines for Opioid Prescription: The Devil Is in the Details Alex M. Rosenau Metrics Cited byHow well do doctors know their patients? 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A Qualitative StudyThe Opioid Prescription Epidemic and the Role of Emergency MedicineEthical Diversity and the Role of Conscience in Clinical MedicineAbusive Prescribing of Controlled Substances — A Pharmacy View 4 June 2013Volume 158, Issue 11Page: 841-842KeywordsAnalgesicsOpioid addictionOpioidsPsychiatry and mental healthSystematic reviewsTreatment guidelinesVeteran careVital signs ePublished: 4 June 2013 Issue Published: 4 June 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...