The CDC has proposed 12 recommendations for clinicians prescribing opioids.
- When initiating opioid therapy, immediate-release opioids at the lowest effective doses are recommended. Extra precautions should be taken when prescribing at or above 50 morphine milligram equivalents (MME) per day, and doses at or above 90 MME per day generally should be avoided.
- For treatment of acute, nontraumatic pain unrelated to major surgery, opioids usually should not be prescribed for more than 3 days.
- For patients with chronic pain, clinicians should discuss the benefits and harms of continued opioid treatment with patients at least every 3 months.
- Providers should use their state’s prescription drug monitoring program to review the patient’s history of controlled substance prescriptions when starting opioids for chronic pain and at least every 3 months during treatment. Urine testing should be performed before initiation and at least annually thereafter.
- Clinicians should avoid prescribing opioids for patients receiving benzodiazepines.