Opioid prescribing for chronic pain
What the major U.S. guidelines recommend, with a link to verify each at the source. A quick-reference summary for clinicians, not medical advice.
Outpatients 18 and older (excludes cancer, sickle cell, palliative, end-of-life). Maximize nonopioid and nonpharmacologic therapy; opioids not first-line for subacute or chronic pain. If used, start immediate-release at lowest effective dose. No hard MME limit, but carefully reassess individual benefits and risks before increasing dosage, with added caution at higher dosages such as 50 MME/day or more. Reevaluate benefits and risks within 1 to 4 weeks of starting or escalating; do not abruptly stop or rapidly taper. Use particular caution with concurrent benzodiazepines; check PDMP; offer naloxone; arrange treatment for opioid use disorder.
Verify at CDC →