The emergency patients who are prescribed opioids for the first time in the emergency department were less likely to become long-term users compared to other medical settings. They are prescribed these powerful painkillers in accordance with The Centers for Disease Control and Prevention (CDC) guidelines. About 5.2 million prescriptions for opioids were analyzed, the findings are published in Annals of Emergency Medicine ("Opioid Prescribing for Opioid-Naïve Patients in Emergency Department and Other Settings: Characteristics of Prescriptions and Association with Long-Term Use").
The findings suggested that the emergency physicians were handing out opioids like candy, said Molly Moore Jeffery, from Mayo Clinic Division of Emergency Medicine Research. The prescribing guidelines publicized the progression to long-term opioid use was lower in the ER. The emergency physicians prescribed opioids for shorter duration, lower daily doses and were less likely for long-acting formulations.
The researchers found that in ED, the opioid prescriptions exceeding 7 days were 84-91% lower than in non-emergency settings. The prescriptions from the ER were 23-37% less likely to exceed 50 morphine milligram equivalents and 33-54% less likely to exceed 90 milligram equivalents (a high dose). The Prescriptions from the ER were 86-92% less likely to be written for long-acting or extended-release formulations than those attributed to non-emergency settings.
The patients receiving opioid prescriptions in the ED were less likely to progress to long-term opioid use. However, some patients progressed to long-term opioid use, i.e., 1.1% with private insurance, 6.2% with disabled Medicare and 3.1% with Medicare (age ≥65 years).
"Over time, prescriptions written in the ER for high dose opioids decreased between 2009- 2011," said Ms. Jeffery. "Less than 5 % of opioid prescriptions from the ER exceeded 7 days, which is much lower than the percentage in non-emergency settings. Further research could help in replicating the success of opioid prescribing in ED in other medical settings."
The emergency patients who are prescribed opioids for the first time in the emergency department were less likely to become long-term users compared to other medical settings. They are prescribed these powerful painkillers in accordance with The Centers for Disease Control and Prevention (CDC) guidelines.