Reference Materials for Emergency Department Staff

Scope of the Problem

Centers for Disease Control and Prevention (2019), published as commentary in the New England Journal of Medicine. No Shortcuts to Safer Opioid Prescribing. 

Centers for Disease Control and Prevention (2014). Fact Sheet: Prescription Drug Overdose in the US.

Centers for Disease Control and Prevention (2014). Vital Signs: Variations Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines –United States, 2012.

Centers for Disease Control and Prevention (2011). Vital Signs: Prescription Painkiller Overdoses in the US.

National Institute on Drug Abuse (2014). Prescription Drugs & Cold Medicines.

Substance Abuse and Mental Health Services Administration (2013). The DAWN Report. Highlights of the 2011 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits.

State Initiatives

Kuehn BM. CDC: Major disparities in opioid prescribing among states - Some states crack down on excess prescribing. JAMA. 2014:312(7):684-686. Article highlights state-specific data on opioid prescribing, legislative efforts, and the impact of these efforts.

AHRQ Health Care Innovations Exchange. Cross Agency Mayoral Task Force Promotes Policies and Initiatives to reduce opioid misuse and related problems, achieves some early successes. March 2014.

Be Aware: State Opioid Prescribing Regulations (PDF). Robert Broida, MD, FACEP.

Regulatory (CMS/FDA)

CMS Letter to South Carolina Hospital Association (PDF). 2013.

CMS Atlanta CMO response to EMTALA / Opioid signage inquiry (PDF). 2013.

US Food and Drug Administration. Consumer Health Information Q&A. Combating misuse and abuse of prescription drugs. July 2010.

Bitterman RA. Is "severe pain" considered an emergency medical condition under EMTALA? ACEP Now, April 2013. This article addresses misconceptions about the treatment of severe pain and what is required under EMTALA.

Prescribing Guidelines

American College of Emergency Physicians. Clinical policy: Critical issues in the prescribing of opioids for adult patients in the emergency department (PDF). Ann Emerg Med. 2012;60:499.525.

New York City Emergency Department Discharge Opioid Prescribing Guidelines.

Pennsylvania Guidelines on the Use of Opioids to Treat Chronic Noncancer Pain. July 2014.

California Medical Board. Guidelines for Prescribing Controlled Substances for Pain (2007).

Prescription Drug Monitoring Programs

AHRQ Innovations Exchange. System gives authorized users Access to Interstate Information on Controlled Substance Prescriptions assisting them in identifying cases of potential misuse. The National Association of Boards of Pharmacy (NAPB) Prescription Monitoring Program (PMP) InterConnect is a data exchange platform that links PMPs that allow authorized prescribers and dispensers to access patient-specific information.

Other

Drug Abuse Warning Network (DAWN). DAWN is a public health surveillance system that monitors drug-related hospital ED visits.

The Joint Commission Sentinel Event Alert. Safe use of opioids in hospitals (2012)

SAMHSA Opioid Overdose Toolkit: Information for Prescribers. The toolkit provides information on patient assessment, use of state PDMPs, treatment agreements, safeguards before prescribing, naloxone prescription consideration, overdoses, liability, and prescriber resources.