George Washington University (GW) researchers discovered the prescription of medications including Percocet, Vicodin, Oxycodone, and Dilaudid were significantly elevated despite only a modest increase in ER visits for painful conditions.
This report was published in the journal Academic Emergency Medicine.
“This trend is especially concerning given dramatic increases in opioid-related overdoses and fatalities in recent years,” said Maryann Mazer-Amirshahi, M.D., co-author of the study and adjunct instructor of emergency medicine at the GW School of Medicine and Health Sciences (SMHS).
“Using prescription opioids to treat acute painful conditions in emergency departments and hospitals might do more harm than good, as they can potentially lead to misuse and addiction.
More needs to be done to monitor opioid prescriptions in emergency departments — having recommended standard approaches may be a good starting point.”
Mazer-Amirshahi and colleagues found that between 2001 and 2010, the percentage of overall emergency department visits where an opioid analgesic was prescribed increased from 20.8 percent to 31 percent.
For some opioids, prescription rates increased dramatically; Dilaudid, one of the most potent yet addictive medications, went up 668.2 percent. But the percentage of visits for painful conditions during the period only increased by four percent, from 47.1 percent in 2001 to 51.1 percent in 2010.
“Emergency department providers are often caught in a difficult position because some have their pay incentivized based on how patients report their satisfaction with their experience.
“The intention is always to provide appropriate pain relief, but many patients have come to expect opioids,” said Jesse Pines, M.D., co-author of the study.
“When patients in pain want opioids, but don’t get them — which is common — they may report a poor experience. We need to carefully consider how to balance these issues when it comes to national policy, particularly local, and national payment policies in this country.”
The study analyzed data from the National Hospital Ambulatory Medical Care Survey, exploring which demographic groups, medications, and reasons for visiting the emergency room may account for this change in prescribing rates.
In their analysis, the authors found the following over the 10-year study period:
Source: George Washington University