The Society of Hospital Medicine has released a consensus statement on safely using opioids for acute, noncancer pain in hospitalized patients. The statement, which appears in the Journal of Hospital Medicine, includes 16 recommendations for clinicians. Among them:
- Restrict opioid use to patients who have severe pain, or those with moderate pain that isn’t well controlled with other medications.
- Avoid use of long-acting and extended-release opioids, including transdermal fentanyl.
- Combine opioids with scheduled nonopioid analgesic drugs and consider also using nonpharmacologic strategies for managing pain.
- When possible, avoid administering opioids concurrently with other drugs that suppress the central nervous system.
- When switching opioids, lower the dose of the new opioid by at least 25%–50% of the calculated equianalgesic dose to account for inter-patient variability in response to opioids.
At discharge, inquire about existing opioids at home and take this information into account when prescribing more opioids.