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Opioid use disorder

A public health emergency

Alexander, Lisa Mustone, EdD, MPH, PA-C; Keahey, David, PA-C, MSPH; Dixon, Katelyn

Journal of the American Academy of PAs: October 2018 - Volume 31 - Issue 10 - p 47–52
doi: 10.1097/
Special Article

ABSTRACT The treatment of patients with acute and chronic pain not attributed to cancer or end-of-life conditions is a challenge for many clinicians. Although CDC guidelines that focus on the primary care setting have provided critical recommendations, evidence-based guidance is lacking on optimal duration of opioid treatment for postoperative and acute care in specialty settings. Over the last 2 decades, the liberal use of opioids has resulted in many unintended consequences, including dependence and abuse, illicit distribution of legally and illegally prescribed opioid medication, progression to IV heroin and an epidemic of overdoses, and most recently an increase in the incidence of HIV among patients sharing syringes, frequently in communities with historically low HIV rates. This article analyzes these complex issues and proposes strategies to help clinicians improve patient care through education and responsible prescribing.

Lisa Mustone Alexander is a professor in the PA program at George Washington University in Washington, D.C., and president of the Physician Assistant Education Association. David Keahey is chief policy and research officer at the Physician Assistant Education Association in Washington, D.C. Katelyn Dixon is a student in the master of public health program at George Washington University. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Copyright © 2018 American Academy of Physician Assistants
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