New Guidelines on Prescribing Opiates in the ED

Shortening duration of treatment, adopting a multimodal, nonopioid model for acute pain management treatment, and establishing a system for notifying primary care providers when their patients are prescribed opiates are high on the list of recommendations just issued by the Texas Hospital Association (THA) for emergency room clinicians. While the guidelines are voluntary, they reflect a growing trend toward institutionalizing opiate prescribing practices in multiple settings around the country. They could reasonably be viewed as a model for the urgent care setting in and beyond Texas, as well. As is the case in urgent care, Texas ED physicians were urged to remind patients that the ED exists to provide care on a short-term basis, pending hospital admission or follow-up outside of the hospital. Such conversations may serve to educate patients who think the 3- to 5-day supply of opiates recommended in the guidelines will be insufficient to treat their pain. The THA developed the guidelines in consultation with its behavioral health council, hospital physician executive committee, and quality-and-patient safety council in an effort to strike a balance between responsible use of opiates and overprescribing or prescribing to patients most likely to develop substance abuse issues.