Ryan Gleber1, Gary M Vilke1, Edward M Castillo1, Jesse Brennan1, Leslie Oyama1, Christopher J Coyne2. 1. University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California 200 West Arbor Drive, Mailcode 8676, San Diego, CA 92103, United States of America. 2. University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California 200 West Arbor Drive, Mailcode 8676, San Diego, CA 92103, United States of America. Electronic address: cjcoyne@ucsd.edu.
Abstract
BACKGROUND: Prescription opioid related deaths have increased dramatically over the past 17 years. Although emergency physicians (EPs) have not been the primary force behind this rise, previous literature have suggested that EPs could improve their opioid prescribing practices. We designed this study to evaluate the trend in emergency department (ED) opioid prescriptions over time during the US opioid epidemic. METHODS: We conducted a retrospective cohort study from July 1, 2012 to June 30, 2018, evaluating all adult patients who presented to two study EDs for a pain-related complaint and received an analgesic prescription upon ED discharge. We compared these data to trends in lay media and medical literature regarding the opioid epidemic. We also evaluated the incidence of repeat ED visits based on the type of analgesic prescriptions provided. RESULTS: Opioid prescriptions decreased from 37.76% to 13.29% over the six year study period. This coupled with an increase in non-opioid medications from 6.12% to 11.33% and an increase in "no prescription" from 56.12% to 75.37%. This corresponded with an increase in the number of publications on the opioid epidemic within the lay-public and medical literature. Additionally, those patients that received no opiates were less likely to require a repeat ED visit. CONCLUSIONS: ED physicians are prescribing less opiates, while increasing the amount of non-narcotic analgesic prescriptions. This may be in response to the literature suggesting that prescription opioids play a large role in the opioids crisis. This decrease in opioid prescriptions did not increase the need for repeat ED visits.
BACKGROUND: Prescription opioid related deaths have increased dramatically over the past 17 years. Although emergency physicians (EPs) have not been the primary force behind this rise, previous literature have suggested that EPs could improve their opioid prescribing practices. We designed this study to evaluate the trend in emergency department (ED) opioid prescriptions over time during the US opioid epidemic. METHODS: We conducted a retrospective cohort study from July 1, 2012 to June 30, 2018, evaluating all adult patients who presented to two study EDs for a pain-related complaint and received an analgesic prescription upon ED discharge. We compared these data to trends in lay media and medical literature regarding the opioid epidemic. We also evaluated the incidence of repeat ED visits based on the type of analgesic prescriptions provided. RESULTS: Opioid prescriptions decreased from 37.76% to 13.29% over the six year study period. This coupled with an increase in non-opioid medications from 6.12% to 11.33% and an increase in "no prescription" from 56.12% to 75.37%. This corresponded with an increase in the number of publications on the opioid epidemic within the lay-public and medical literature. Additionally, those patients that received no opiates were less likely to require a repeat ED visit. CONCLUSIONS: ED physicians are prescribing less opiates, while increasing the amount of non-narcotic analgesic prescriptions. This may be in response to the literature suggesting that prescription opioids play a large role in the opioids crisis. This decrease in opioid prescriptions did not increase the need for repeat ED visits.
Authors: Lauren R Gorfinkel; Deborah Hasin; Andrew J Saxon; Melanie Wall; Silvia S Martins; Magdalena Cerdá; Katherine Keyes; David S Fink; Salomeh Keyhani; Charles C Maynard; Mark Olfson Journal: J Pain Date: 2022-02-08 Impact factor: 5.383
Authors: Vanessa Troiani; Richard C Crist; Glenn A Doyle; Thomas N Ferraro; Donielle Beiler; Stephanie Ranck; Kortney McBryan; Margaret A Jarvis; Jordan S Barbour; John J Han; Ryan J Ness; Wade H Berrettini; Janet D Robishaw Journal: BMC Med Genomics Date: 2021-10-26 Impact factor: 3.063