Opioid Safety

Abstract

This chapter provides an overall view of the US opioid epidemic, with information on prescription opioid use, overdose rates, and comorbidities that put individual patients at risk of poor outcomes when prescribed opioids for chronic non-cancer pain. In addition, opioid use disorder and medications used to treat this disease must be standardized in healthcare. The chapter uses two patient cases to illustrate common prescribing dilemmas for clinicians: a patient with multiple chronic medical conditions co-prescribed opioids and benzodiazepines and a patient prescribed opioids who is cut off of the prescription, stigmatized, and not provided a safe way to taper off of opioids or treat the resultant opioid use disorder by multiple prescribers. A thorough discussion of the risks of opioid prescribing as well as the risks of abruptly stopping prescription opioids follows, along with a detailed set of solutions for safer opioid prescribing that health systems can put in place. The key lessons can help guide inpatient and outpatient clinicians as well as administrators on ways to address opioid safety and to improve patient outcomes when experiencing chronic non-cancer pain and treat opioid use disorder.