Journal article
Substance use history is associated with lower opioid use for emergency department pain management
The American journal of emergency medicine, Vol.50, pp.187-190
12/2021
DOI: 10.1016/j.ajem.2021.08.005
PMID: 34388686
Abstract
In the current national opioid crisis, where 10% of the US population has or has had a substance use disorder (SUD), emergency department (ED) clinicians are challenged when treating pain in the ED and when prescribing pain medications to these patients on discharge as there is concern for contributing to the cycle of addiction. The objective of this study was to examine whether acute pain is treated differently in patients with and without current or past SUD by quantifying the amount of opioid analgesia given in the ED and prescribed on discharge.
Retrospective cohort study of patients presenting to a 60,000-visit tertiary referral ED with acute fracture between January 1, 2016 and June 30, 2019. The primary exposure was indication of SUD (SUD+) versus those without SUD (SUD-). The primary outcome was receipt of opioids in the ED, and the secondary outcome was opioids prescribed at discharge.
117 matched pairs (n = 234) were included in the sample. Overall, 53.4% and 62.4% of patients received opioids in the ED or a prescription for opioids, respectively. Opioid receipt in the ED was lower among SUD+ patients compared to SUD- patients (48.7% and 58.1%, respectively; aOR: 0.33; 95%CI: 0.14, 0.77). Similarly, receipt of a prescription for opioids was lower among SUD+ patients compared to SUD- patients (56.4% and 68.4%, respectively; aOR: 0.50; 95%CI: 0.26, 0.95).
Overall, ED clinicians gave opioids less frequently to SUD+ patients in the ED and on discharge from the ED compared to SUD- patients with acute pain secondary to acute fracture.
•Substance use history was associated with a decreased likelihood of receiving opioids in the Emergency Department.•Substance use history was associated with a decreased likelihood of receiving an opioid prescription at discharge.•When prescribed opioids, amounts (in milligram morphine equivalent) were similar among those with and without SUD.
Details
- Title: Subtitle
- Substance use history is associated with lower opioid use for emergency department pain management
- Creators
- Skyler Chouinard - University of Iowa Hospitals and ClinicsJ. Priyanka Vakkalanka - University of IowaMimi Williams - University of IowaJoshua Radke - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- The American journal of emergency medicine, Vol.50, pp.187-190
- DOI
- 10.1016/j.ajem.2021.08.005
- PMID
- 34388686
- NLM abbreviation
- Am J Emerg Med
- ISSN
- 0735-6757
- eISSN
- 1532-8171
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 12/2021
- Academic Unit
- Epidemiology; Emergency Medicine; Injury Prevention Research Center
- Record Identifier
- 9984296974902771
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