Critical Issues in the Prescribing of Opiods for Adult Patients in the Emergency Department
(2) Given a lack of demonstrated evidence of superior efficacy of either opioid or nonopioid analgesics and the individual and community risks associated with opioid use, misuse, and abuse, opioids should be reserved for more severe pain or pain refractory to other analgesics rather than routinely prescribed.
(3) If opioids are indicated, the prescription should be for the lowest practical dose for a limited duration (eg, 1 week), and the prescriber should consider the patient’s risk for opioid misuse, abuse, or diversion.
(2) If opioids are prescribed on discharge, the prescription should be for the lowest practical dose for a limited duration (eg, 1 week), and the prescriber should consider the patient’s risk for opioid misuse, abuse, or diversion.
(3) The clinician should, if practicable, honor existing patient-physician pain contracts/treatment agreements and consider past prescription patterns from information sources such as prescription drug monitoring programs. (C)
Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department
June 1, 2020
Last Updated Month/Year
July 10, 2023
External Publication Status
Country of Publication
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Emergency care
Physician, paramedic emt, nurse, nurse practitioner, physician assistant
D009293 - Opioid-Related Disorders
Prescribing of Opioids, Adult Patients, Emergency Department, Critical issues
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Opioids; Hatten BW, Cantrill SV, Dubin JS, Ketcham EM, Runde DP, Wall SP, Wolf SJ. Clinical Policy: Critical Issues Related to Opioids in Adult Patients Presenting to the Emergency Department. Ann Emerg Med. 2020 Sep;76(3):e13-e39. doi: 10.1016/j.annemergmed.2020.06.049. PMID: 32828340.