Photo Credit: Stas V

The following is a summary of “Frequency of persistent opioid use 6 months after exposure to IV opioids in the Emergency Department: A Prospective cohort study,” published in the August 2024 issue of Emergency Medicine by Irizarry et al.

The rising prevalence of opioid use disorder has led to concerns about the routine use of intravenous opioids in the Emergency Department (ED) for acute severe pain.

Researchers conducted a retrospective study to specify the incidence of persistent opioid use among opioid-naïve patients exposed to IV opioids in the ED.

They examined Opioid-naïve adults with severe pain who received IV opioids in the ED and were followed up for 6 months by telephonic interviews and state opioid prescription database reviews. Persistent opioid use was defined as filling 6 or more opioid prescriptions in the 6 months after the ED visit, or an average of 1 prescription per month.

The results showed that of the 1,555 screened patients, 506 met entry criteria and provided analyzable data. Morphine was the most frequently administered IV opioids in the ED (478, 94%), followed by hydromorphone (20, 4%), while 8 of the 506 patients (2%) received both IV morphine and hydromorphone, and 63 (12%) participants have prescribed an opioid for use after the ED visit. At the same time, 1 patient out of 506 (0%) met the apriori criteria for persistent opioid use within 6 months.

Investigators concluded that among 506 opioid naïve ED patients administered IV opioids for acute severe pain, only one used opioids persistently during the subsequent 6 months,  suggesting that the use of IV opioids for acute pain in the ED is extremely unlikely to lead to opioid use disorder.

Source: sciencedirect.com/science/article/abs/pii/S0736467924000805