Rigorous clinical practice guidelines could help physicians reduce rates of opioid misuse and overdose deaths among patients with chronic pain, according to an article published in Annals of Internal Medicine. Over the past two decades, rates of opioid abuse and overdose deaths have increased dramatically, highlighting the need for high-quality prescribing guidelines. Recent efforts have focused on redefining standards of care for patients with chronic pain, who may be prescribed opioids for long-term use. Researchers reviewed 13 published opioid prescribing guidelines to evaluate the quality of guidelines on using opioids to treat chronic pain and to compare recommendations related to mitigating risks for overdose and misuse. The quality of evidence that guidelines provided in support of their recommendations was also assessed. While the methods for development and clinical emphasis of the guidelines varied, the researchers found consensus across several important areas. All of the guidelines agreed on using upper dosing thresholds; exercising caution with certain medications; paying attention to possible interactions with other medications or diseases; and using risk assessment tools, treatment agreements, and urine drug testing to reduce abuse. The guidelines differed greatly in quality, however. Only two of the 13 guidelines assessed received high ratings based on their evidence and methods. Seven other guidelines were found to be of intermediate quality and the reviewers recommended against using the remaining four.