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IntroductionThe purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM).MethodsWe conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP.ResultsWe found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion.ConclusionThis study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.

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PrefaceAll of us who have worked on this curriculum are career emergency physicians (EPs) who have become leaders with a focus on emergency medicine (EM) quality and safety.About 2 years ago, I approached my colleagues of the American College of Emergency Physicians Quality Improvement and Patient Safety (ACEP QIPS) Section and dreamed an idea of creating an EM quality and safety curriculum: an outline that would explain a topic few EPs understand. That outline would be used as a curriculum to teach our EM residents (and even our attendings, physician's assistants, and nurse leaders) about EM quality and safety.My goal is for this curriculum to become an integral part of every EM residency program and department. We know that quality and safety in patient care does not happen by accident. We must teach these concepts to everyone on our emergency department (ED) team. The safety of our patients depends on this.I would like to thank each of the authors who spent many months on this project, along with the ACEP QIPS Section and ACEP Quality and Performance Committee. Also, I would like to thank ACEP staff Angela Franklin and Idania Lorenti for their help in getting this project to completion. I must also sincerely acknowledge the early work and ideas generated by Drs. Shari Welch and David John: their contributions clearly helped shape this article.-John J. Kelly, DO ACADEMIC EMERGENCY MEDICINE 2010; 17:e110-e129 ª

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