TY - JOUR
T1 - Association of Emergency Department Opioid Initiation with Recurrent Opioid Use
AU - Hoppe, Jason A.
AU - Kim, Howard
AU - Heard, Kennon
N1 - Funding Information:
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org ). The authors have stated that no such relationships exist and provided the following details: Professional research assistant support for the project was provided by a pilot grant from the University of Colorado Department of Emergency Medicine. The use of Research Electronic Data Capture in this project was supported by National Institutes of Health (NIH) / National Center for Research Resources (NCRR) Colorado CTSI grant UL1 RR025780 .
Publisher Copyright:
© 2014 American College of Emergency Physicians.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Study objective: Acute pain complaints are commonly treated in the emergency department (ED). Short courses of opioids are presumed to be safe for acute pain; however, the risk of recurrent opioid use after receipt of an ED opioid prescription is unknown. We describe the risk of recurrent opioid use in patients receiving an opioid prescription from the ED for an acute painful condition. Methods: This is a retrospective cohort study of all patients discharged from an urban academic ED with an acute painful condition during a 5-month period. Clinical information was linked to data from Colorado's prescription drug monitoring program. We compared opioid-naive patients (no opioid prescription during the year before the visit) who filled an opioid prescription or received a prescription but did not fill it to those who did not receive a prescription. The primary outcome was the rate of recurrent opioid use, defined as filling an opioid prescription within 60 days before or after the first anniversary of the ED visit. Results: Four thousand eight hundred one patients were treated for an acute painful condition; of these, 52% were opioid naive and 48% received an opioid prescription. Among all opioid-naive patients, 775 (31%) received and filled an opioid prescription, and 299 (12%) went on to recurrent use. For opioid-naive patients who filled a prescription compared with those who did not receive a prescription, the adjusted odds ratio for recurrent use was 1.8 (95% confidence interval 1.3 to 2.3). For opioid-naive patients who received a prescription but did not fill it compared with those who did not receive a prescription, the adjusted odds ratio for recurrent use was 0.8 (95% confidence interval 0.5 to 1.3). Conclusion: Opioid-naive ED patients prescribed opioids for acute pain are at increased risk for additional opioid use at 1 year.
AB - Study objective: Acute pain complaints are commonly treated in the emergency department (ED). Short courses of opioids are presumed to be safe for acute pain; however, the risk of recurrent opioid use after receipt of an ED opioid prescription is unknown. We describe the risk of recurrent opioid use in patients receiving an opioid prescription from the ED for an acute painful condition. Methods: This is a retrospective cohort study of all patients discharged from an urban academic ED with an acute painful condition during a 5-month period. Clinical information was linked to data from Colorado's prescription drug monitoring program. We compared opioid-naive patients (no opioid prescription during the year before the visit) who filled an opioid prescription or received a prescription but did not fill it to those who did not receive a prescription. The primary outcome was the rate of recurrent opioid use, defined as filling an opioid prescription within 60 days before or after the first anniversary of the ED visit. Results: Four thousand eight hundred one patients were treated for an acute painful condition; of these, 52% were opioid naive and 48% received an opioid prescription. Among all opioid-naive patients, 775 (31%) received and filled an opioid prescription, and 299 (12%) went on to recurrent use. For opioid-naive patients who filled a prescription compared with those who did not receive a prescription, the adjusted odds ratio for recurrent use was 1.8 (95% confidence interval 1.3 to 2.3). For opioid-naive patients who received a prescription but did not fill it compared with those who did not receive a prescription, the adjusted odds ratio for recurrent use was 0.8 (95% confidence interval 0.5 to 1.3). Conclusion: Opioid-naive ED patients prescribed opioids for acute pain are at increased risk for additional opioid use at 1 year.
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U2 - 10.1016/j.annemergmed.2014.11.015
DO - 10.1016/j.annemergmed.2014.11.015
M3 - Article
C2 - 25534654
AN - SCOPUS:84929028750
VL - 65
SP - 493-499.e4
JO - Journal of the American College of Emergency Physicians
JF - Journal of the American College of Emergency Physicians
SN - 0196-0644
IS - 5
ER -