Opioid Stewardship in Practice: Safer Prescribing, Non-Opioid Strategies and Harm Reduction Across Care Settings-FREE NO CME-Module-2

Video Transcription

Video Summary

This micro-learning on opioid stewardship uses James, a 68-year-old man with obstructive sleep apnea and chronic kidney disease after surgery, to show how to reduce opioid-related harm in high-risk hospitalized patients. Evidence from the PRODIGY trial and CDC guidance highlights that older age, sleep-disordered breathing, and renal impairment increase the risk of respiratory depression. The key strategy is multimodal, opioid-sparing pain control: identify high-risk patients early, use ERAS pathways, schedule non-opioids first (especially acetaminophen), use NSAIDs and gabapentinoids cautiously or avoid them in CKD, add regional analgesia when possible, and incorporate non-pharmacologic measures like positioning, ice/heat, and music or TENS. If opioids are needed, use the lowest effective PRN dose, not scheduled dosing, and monitor sedation and respiratory status closely. The takeaway: opioids should be breakthrough therapy within a broader recovery-focused plan.

Keywords

opioid stewardship

multimodal pain control

respiratory depression

high-risk hospitalized patients

opioid-sparing analgesia