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JAMA Network Insights
November 11, 2020

Five Things to Know When a Psychiatric Patient Is Prescribed Opioids for Pain

Author Affiliations
  • 1Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
JAMA Psychiatry. 2021;78(2):220-221. doi:10.1001/jamapsychiatry.2020.3547

Opioids are commonly prescribed for chronic pain. In the United States, opioid prescribing increased 4-fold in the early 2000s, accompanied by increases in opioid-related overdose and addiction. Therefore, policy efforts have focused on reducing inappropriate or unnecessary opioid prescribing. Nonetheless, opioids remain a management option for chronic pain in selected patients. Because the prevalence of psychiatric conditions is high in those with chronic pain, psychiatrists often encounter patients prescribed opioids and can play an essential role in management. This article summarizes 5 key things for psychiatrists to know in this situation.

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1 Comment for this article
Avoiding stigma
Robert Kerns, PhD | Yale University
Dr. Chou and others publishing in JAMA should strive to avoid use of stigmatizing terms such as "psychiatric patient." Furthermore, although it may be understandable that authors publishing in JAMA may be primarily physician readers, in this and many other cases, it is disappointing and potentially limiting to call out "psychiatrists" versus the much broader array of healthcare professionals who provide care for persons with mental health problems. In this case, it is noteworthy that the nonpharmacological and noninvasive approaches cited as alternatives to medications have largely been developed and empirically evaluated by teams led by psychologists, not psychiatrists, and other non-physicians. Use of terms and labels that are more inclusive and reflective of a diverse practice community is preferable.