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November 1, 2016

Opioids Out, Cannabis In: Negotiating the Unknowns in Patient Care for Chronic Pain

Author Affiliations
  • 1Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
  • 2Department of Psychiatry, Oregon Health & Science University, Portland
  • 3Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
JAMA. 2016;316(17):1763-1764. doi:10.1001/jama.2016.13677

With the current nationwide epidemic of opioid abuse, dependence, and fatalities, clinicians are being asked by federal agencies and professional societies to control their prescribing of narcotic medications for pain. Federal guidelines emphasize tapering, discontinuing, and limiting initiation of these drugs except in provision of end-of-life care.1 Reducing reliance on opioids, however, is a massive task. According to one estimate, more than 650 000 opioid prescriptions are dispensed each day in the United States.2 Unless the nation develops an increased tolerance to chronic pain, reduction in opioid prescribing leaves a vacuum that will be filled with other therapies.

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