, Volume 26, Issue 9, pp 951-952

Safe Opioid Prescribing: A Long Way to Go

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Chronic pain is one of the most common reasons why patients visit a physician; yet, physicians are poorly trained to manage it. Despite centuries-long therapeutic use of opioids for pain, they fell out of favor for most of the 20th century in the US. However, in the 1980s, medical literature began to support the practice of prescribing opioids for chronic non-cancer pain.1 Opioid prescribing then escalated over the past two decades,2 despite lack of strong evidence supporting this practice.3 Although it started as an antidote to under-treatment of pain, increased opioid prescribing has paralleled increases in opioid misuse including overdoses, diversion and addiction.4,5. Over the last decade, the medical and public health communities have begun to address this problem by cautioning that all patients prescribed opioids carry some degree of risk for opioid misuse. Recent clinical guidelines based on expert consensus now endorse universal assessment for opioid misuse risk and monitoring