Opioids have gotten a ton of attention lately from the mainstream media (here’s one sample, from National Public Radio) which is great news – the public needs to know more about the serious risks that accompany opioid use, since opioids currently cause about 16,000 fatalities annually in the US alone, up from 14,800 in 2008.

Reed Group just put another tool into the hands of people who need to evaluate opioid use. Reed Group DisabilityGuidelines™ now includes new opioids guidance, provided and independently researched by ACOEM (the American College of Occupational and Environmental Medicine.)

Among the chapter’s findings and recommendations:


  • 80-94% of opioid trials have industry conflicts (funding and/or conflicts of interest in the trials).
  • People in safety sensitive jobs should not take opioids. A systemic review found all 12 studies of motor vehicle crashes supported an elevated risk of crashes among drivers taking opioids. Other guidelines currently on the market don’t include this warning, and/or do not back it up with scientific review.
  • Suggests a 50mg morphine equivalent dose is the appropriate limit.  Prior guidance used elsewhere and based mostly on expert opinion has been 100-120mg, possibly allowing fatalities to occur.
  • No comparative trial shows that an opioid is superior to another medication (out of 28 trials.)
  • Most patients in opioid trials do not tolerate opioids and drop out in various phases of the trials.
  • No evidence shows the long-term efficacy of opioids – the longest placebo controlled trial lasted only 4 months

The new opioids chapter includes an opioid treatment agreement, designed to help health care providers and patients use opioids appropriately. This form can also be downloaded for free; we’re hoping that by making this form widely available, Reed Group can help patients and prescribing clinicians, as well as others whose profession requires a broad understanding of appropriate opioid use, including insurers, employers and TPAs.

And about the new name…element(14)

Reed Group DisabilityGuidelines™ is the new name for the combined MDGuidelines™ and ACOEM Practice Guidelines, which are both available on the web via a single subscription (or separately, for subscribers who need a single set of information.) Our DisabilityGuidelines™ contain all the reliable guidelines, predictive model, and evidence-based treatments that have made them the leading favorite of physicians, utilization reviewers, and other professionals. New name, a fresher look to our website…same high-quality content.

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