Hospital Group Offers Recommendations on Safe Use of Opioids for Inpatients

April 13, 2018 by Dr. Clemens Leave a Comment

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.

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