Overuse of Opioid Painkillers in the ER

opioid painkillersBetween 2001 and 2010, there has been a dramatic increase in the use of prescription opioid painkillers in United States’ emergency departments.[1] Researchers at George Washington University found that medicine—including Percocet, Vicodin, Oxycodone, and Dilaudid—had increased significantly, despite the modest increase in ER visits for painful conditions.1

“This trend is especially concerning given dramatic increases in opioid-related overdoses and fatalities in recent years,” said co-author of the study and instructor of emergency medicine at the George Washington School of Medical and Health Sciences, Maryann Mazer-Amirshahi. “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.”1

Researchers found that between 2001 and 2010, the percentage of emergency department visits where an opioid analgesic was prescribed had increased from 20.8 percent to 31 percent.1 Most unsettling, the prescription rates for Dilaudid, one of the most potent and addictive opioids increased by 668.2 percent alone.1 Furthermore, the percentage of visits to ERs for painful conditions only rose by a mere four percent.1

“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,” said co-author of the study, Jesse Pines, MD. “The intention is always to provide appropriate pain relief, but many patients have come to expect opioids. When patients in pain want opioids, but don’t get them—which is common—they may report a poor experience. We need to carefully balance these issues when it comes to national policy, particularly local, and national payment policies in this country.”1

The researchers analyzed data from the National Hospital Ambulatory Medical Care Survey for their study, which explored demographic groups, medicines, and reasons for emergency room visits.1 The researchers found that opioid-prescribing increased among all age groups and in both black and whites.1 The largest proportional increases were found in the Midwestern states, but the highest frequency of opioids prescribed were in the Western states, with the lowest being in the Northeast states.1 Prescribing opioids was found to be more common in urban emergency departments and nonprofit hospitals, and the prescribing of all opioid analgesics, except for codeine and meperidine, were found to have increased.1

The issue of the overuse of prescription opioid analgesics has become far too common throughout the country.

[1] Nauert, R. (2014). Are Painkillers Overused in the ER?. Psych Central. Retrieved on March 20, 2014, from http://psychcentral.com/news/2014/03/17/are-painkillers-overused-in-the-er/67206.html

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