NYC Recommendations for Prescribing Opioids in Emergency Departments
March 8, 2013, 12:52 am
Improving Opioid Prescribing: The New York City Recommendations. Juurlink DN et al. JAMA 2013 Mar 6;309:879-880.
In January of this year, New York City issued guidelines concerning prescribing opioids in the city’s public emergency departments. (To read the guidelines, click here.) Some private hospital adopted the guidelines voluntarily.
Key recommendations include:
- Start with the lowest possible effective dose of a short-acting preparation is treatment with an opioid is indicated.
- Prescribe for no more than a short course, usually 3 days or less.
- Assess for opioid misuse or addiction.
- Do not start treatment with a long-acting or extended release preparation.
- Avoid if possible prescribing opioid analgesics to patients taking a benzodiazepine or other medications that cause respiratory depression.
This short well-written Viewpoint piece discusses the reasons why the NEw York City guidelines are necessary and important. I have covered many of these issues in a just-published Emergency Medicine News column “the Dark Truth Behind pain as the Fifth Vital Sign”. To read it, click here.