The Department of Health and Human Services released its “Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics,” which provides advice to clinicians who are contemplating or initiating a reduction in opioid dosage or discontinuation of long-term opioid therapy for chronic pain.
After increasing every year for more than a decade, annual opioid prescriptions in the United States peaked at 255 million in 2012 and then decreased to 191 million in 2017. More judicious opioid analgesic prescribing can benefit individual patients as well as public health when opioid analgesic use is limited to situations where the benefits of opioids are likely to outweigh risks. At the same time, opioid analgesic prescribing changes — such as dose escalation, dose reduction or discontinuation of long-term opioid analgesics — have the potential to harm or put patients at risk if not made in a thoughtful, deliberative, collaborative and measured manner. (Trish Anderson)