Background: Over the past 2 decades, prescription opioid sales and overdose deaths have quadrupled (1). Risk for unintentional overdose is increased when longer-acting opioids and higher dosages are prescribed (2, 3). Older patients are particularly vulnerable to opioid-related complications and injury (4). Addressing these risks, the 2016 opioid prescribing guidelines from the Centers for Disease Control and Prevention (2) suggest a trial of nonopioid therapies before opioid initiation, use of opioids only when expected benefits outweigh risks, reassessment of risks and benefits when prescribing dosages greater than 50 morphine milligram equivalents (MME) per day, and prescribing no more than 90 MME/d.

中文翻译：

---

2006年至2015年处方阿片类药物的Medicare处方保险范围限制

背景：在过去的20年中，处方阿片类药物的销售和过量死亡导致的人数增加了三倍（1）。当开出长效阿片类药物并开出更高剂量的处方药时，无意用药过量的风险会增加（2、3）。老年患者特别容易遭受阿片类药物相关的并发症和伤害（4）。针对这些风险，疾病控制与预防中心的《 2016年阿片类药物处方指南》（2）建议在阿片类药物启动前进行非阿片类药物治疗试验，仅当预期收益大于风险时才使用阿片类药物，当处方剂量大于每天50毫克吗啡毫克当量（MME），规定每日不超过90毫克MME。