Emergency Department Opioid Prescriptions on the Rise

The frequency at which opioid painkillers are being prescribed in emergency departments has risen dramatically in recent years. The number of emergency visits that are related to pain management has not seen a significant rise, but the number of prescriptions for opioids has risen despite that fact. Researchers studied data from US hospital emergency departments from 2001-2008 in an attempt to further understand this upward trend of prescribing pain medications to patients who may be being treated in the emergency department for an unrelated illness. The analysis of data focused on the six most commonly prescribed opioids: hydromorphine, oxycodone, meperidine, morphine, codeine, and hydrocodone. The researchers also studied a patient’s age, type of insurance, and other demographics during the course of their study.

Overall, visits that were pain-related and also non-pain saw opioid prescriptions increase over 49% throughout the course of the research study. In 2001, 20.1% of patients visiting the emergency department were prescribed opioids, whereas in 2008, 31% of patients being treated in the emergency department were prescribed opioid medication. Schedule II opioids were prescribed to patients at a relevant rate of 90%. Schedule II opioids were prescribed in 7.8% of cases in 2001, and were at a high of 14.5% in 2010.

The study indicates that opioid prescribing has increased significantly across all age groups, with prescribing rates the highest in the Midwest. Midwestern emergency patients seeking treatment in 2001 received a prescription for opiates 18.8% of the time, and in 2010, the number of patients being prescribed opioids was 30.7%. These medications were more commonly prescribed in the West, whereas Northeastern states saw the least opioid prescription increase among the states. These increases are caused by many factors, though research suggests that it is a result of recent concern that pain is under-treated. The authors of the study raise concerns that opioids may be prescribed where they are not needed, and that better guidelines and patient pain assessments should be put into place.

Pharmacists can do their part to help patients manage pain by ensuring that prescriptions come with their assigned literature, and review it with their patient upon pickup. Pickup can also be used to answer any questions that a patient may have about their opioid medication, and remind patients of the dosing schedule that their prescription requires. Hospital pharmacists can verify the need for opioids with the attending physicians.

Opioid abuse can be common in some areas, and tracking your pharmacy’s records to ensure that prescription abuse is not occurring is important. Communities can benefit from their local pharmacy providing literature regarding the signs of prescription painkiller abuse, where to go for help, and local rehabilitation centers. Offering this information to patients may help save a person from addiction, and combat the abuse of opioid medication that is occurring today. Pharmacists can do their part to educate and inform their patients as to the best practices regarding their pain management by following simple informative steps, and checking in with patients to ensure that their pain levels are manageable without abusing their medication.