KEY POINTS
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Prevention of harms from opioids prescribed by physicians is complicated by the need to ameliorate patients’ suffering from acute pain.
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Opioid-naive patients pose a particular challenge, as they may seem to clinicians to be at low risk of harms from a new short-term opioid prescription, yet they may be at highest incremental risk.
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Guidelines to prevent clinician-initiated opioid use disorder, misuse, and related harms in opioid-naive individuals are lacking.
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The development of guidelines on the effectiveness of screening or other interventions to prevent opioid harms in opioid-naive patients has been hindered by minimal evidence and absence of validated screening or other preventive tools for the target population, as well as a lack of standard definitions of “opioid naive” and “short course” prescriptions.
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Research and guidance in this area are long overdue.