According to CDC guidelines, clinicians are advised to calculate the opioid dosage morphine milligram equivalent (MME). For patients taking ≥ 50 MME/day total (≥ 50 mg hydrocodone; ≥ 33 mg oxycodone), clinicians are advised to increase frequency of follow-up and consider offering naloxone. Guidelines state that clinicians should avoid increasing dosage to ≥ 90 MME/day or carefully justify a decision to titrate dosage to ≥ 90 MME/day.
The CDC further recommends that clinicians evaluate benefits and harms with patients within 1-4 weeks of initiating opioid therapy for chronic pain or of dose escalation. They also state that clinicians should evaluate benefits and harms of continued therapy every 3 months or more frequently. Clinicians should also observe patients for signs of oversedation or overdose risk to evaluate risk for harm or misuse. If those signs are present, take action by checking prescription drug monitoring program data and tapering the dose. If indicated, check for opioid use disorder and refer for treatment where indicated.
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Cite this: Mary L. Windle. Rapid Rx Quiz: Opioids - Medscape - Jul 08, 2022.