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Prescribing Opioids for Pain

To identify the key insights or developments described in this article
1 Credit CME

Within the context of the opioid crisis, improving care for patients experiencing pain, from acute to chronic, has been the focus of multiple stakeholders.1 Chronic pain alone affects approximately 20% of US adults, and many people experiencing pain do not get optimal relief despite a wide variety of nonopioid, opioid, and nonpharmacologic treatments due to limited evidence, inadequate access, and health disparities.1,2 Although release of the 2016 Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain was associated with fewer opioid prescriptions, there was also an association with decreased access to opioids, abandonment, and abrupt discontinuation.3,4

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Article Information

Corresponding Author: Mim Ari, MD, Department of Medicine, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 (mim.ari@bsd.uchicago.edu).

Published Online: April 24, 2023. doi:10.1001/jama.2023.6539

Conflict of Interest Disclosures: None reported.

References
1.
US Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force Report. Published 2019. Accessed April 19, 2023. https://www.hhs.gov/sites/default/files/pmtf-final-report-2019-05-23.pdf
2.
Dowell  D , Ragan  KR , Jones  CM ,  et al.  CDC clinical practice guideline for prescribing opioids for pain—United States, 2022.   MMWR Recomm Rep. 2022;71(3):1-95. doi:10.15585/mmwr.rr7103a1PubMedGoogle ScholarCrossref
3.
Dowell  D , Haegerich  T , Chou  R .  No shortcuts to safer opioid prescribing.   N Engl J Med. 2019;380(24):2285-2287. doi:10.1056/NEJMp1904190PubMedGoogle ScholarCrossref
4.
Bohnert  ASB , Guy  GP  Jr , Losby  JL .  Opioid prescribing in the United States before and after the Centers for Disease Control and Prevention’s 2016 opioid guideline.   Ann Intern Med. 2018;169(6):367-375. doi:10.7326/M18-1243PubMedGoogle ScholarCrossref
5.
Chou  R , Wagner  J , Ahmed  AY ,  et al.  Treatments for Acute Pain: A Systematic Review. Agency for Healthcare Research and Quality; 2020. doi:10.23970/AHRQEPCCER240
6.
Chou  R , Hartung  D , Turner  J ,  et al.  Opioid Treatments for Chronic Pain. Agency for Healthcare Research and Quality; 2020. doi:10.23970/AHRQEPCCER229
7.
Ray  WA , Chung  CP , Murray  KT ,  et al.  Prescription of long-acting opioids and mortality in patients with chronic noncancer pain.   JAMA. 2016;315(22):2415-2423. doi:10.1001/jama.2016.7789PubMedGoogle ScholarCrossref
8.
Agnoli  A , Xing  G , Tancredi  DJ ,  et al.  Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids.   JAMA. 2021;326(5):411-419. doi:10.1001/jama.2021.11013PubMedGoogle ScholarCrossref
9.
Dowell  D , Compton  WM , Giroir  BP .  Patient-centered reduction or discontinuation of long-term opioid analgesics.   JAMA. 2019;322(19):1855-1856. doi:10.1001/jama.2019.16409PubMedGoogle ScholarCrossref
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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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