NYC Health Dept., ER Doctors Clash Over Opioid Guidelines
(HealthDay News) – There is uncertainty as to whether the New York City Emergency Department Discharge Opioid Prescribing Guidelines will aid emergency physicians as they weigh the complex decisions of relieving patient pain while working to ensure patient safety, according to opposing viewpoints published online April 8 in the Annals of Internal Medicine.
Hillary V. Kunins, MD, from the New York City Department of Health and Mental Hygiene in Queens, and colleagues say that New York City hospitals have endorsed the guidelines, which provide practical recommendations and appreciated support to help physicians determine when the benefits of opioids are likely to outweigh the risks and how to make opioid prescription less risky.
Alex M. Rosenau, DO, the president-elect of the American College of Emergency Physicians, writes in a separate editorial that the guidelines may improperly target emergency room physicians. He cites evidence that emergency physicians are responsible for writing a very small percentage of immediate-release opioid prescriptions and extended or long-acting opioid prescriptions. He argues that emergency physicians must not be constrained in their ability to prescribe for patients in legitimate need of pain relief, particularly for those who will need to wait for follow-up care.
"We believe that the guidelines promote best practices that minimize the risks of opioids and maximize their benefits, because use is recommended only when benefit is likely," Kunins writes.