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Opioid Prescribing in Emergency Departments

The Prevalence of Potentially Inappropriate Prescribing and Misuse

Bibliographic Data

ID9100577
AuthorsJoseph E Logan (Centers for Disease Control and Prevention), Joseph Logan, Ying Liu (0000-0001-5584-7805, Centers for Disease Control and Prevention), Leonard J Paulozzi (Centers for Disease Control and Prevention), Leonard Paulozzi, Kun Zhang (0000-0003-1636-5373, Centers for Disease Control and Prevention), Christopher Jones (0000-0003-0450-1411, Centers for Disease Control and Prevention)
Year2013
Volume51
Issue8
Pages646-653
Publication date2013-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e318293c2c0
PMID23632597
OpenAlexW2008681174
LanguageEN
Citations received6
References cited14

OBJECTIVE: Emergency departments (EDs) routinely provide care for patients seeking treatment for painful conditions; however, they are also targeted by people seeking opioid analgesics for nonmedical use. This study determined the prevalence of indicators of potential ED opioid misuse and inappropriate prescription practices by ED providers in a large, commercially insured, adult population. RESEARCH DESIGN AND INDICATORS: We analyzed the 2009 Truven Health MarketScan Research Databases to examine the ED visits of enrollees aged 18-64 years. Indicators used to mark potential inappropriate use included opioid prescriptions overlapping by one week or more; overlapping opioid and benzodiazepine prescriptions; high daily doses (≥100 morphine milligram equivalents); long-acting/extended-release (LA/ER) opioids for acute pain, and overlapping LA/ER opioids. Analyses were stratified by sex. RESULTS: We identified 400,288 enrollees who received at least one ED opioid prescription. At least one indicator applied to 10.3% of enrollees: 7.7% had high daily doses; 2.0% had opioid overlap; 1.0% had opioid-benzodiazepine overlap. Among LA/ER opioid prescriptions, 21.7% were for acute pain, and 14.6% were overlapping. Females were more likely to have at least one indicator. CONCLUSIONS: In some instances, the prescribing of opioid analgesics in EDs might not be optimal in terms of minimizing the risk of their misuse. Guidelines for the cautious use of opioid analgesics in EDs and timely data from prescription drug monitoring programs could help EDs treat patients with pain while reducing the risk of nonmedical use

Benzodiazepine · Emergency department · Environmental health · Medical prescription · Opioid · Opioid use disorder · Population · Prescription Drug Misuse · Psychiatry · Emergency Medicine · Internal Medicine · Medicine · Opioid Use Disorder Treatment · Pain Management and Opioid Use · Pediatric Pain Management Techniques · Pharmacology

  • The Use of a Prescription Drug Monitoring Program to Develop Algorithms to Identify Providers With Unusual Prescribing Practices for Controlled Substances

    Open Access•Christopher L Ringwalt, Christopher Ringwalt et al.•The Journal of Primary Prevention•2015

  • Opioids and pain in the emergency department

    Jay Baruch, Stacey Springs•Medical Humanities•2018

  • Primary Care - A key route for distribution of naloxone in the community

    Open Access•Ján Klimas, Helen Tobin et al.•International Journal of Drug…•2016

  • Opioid overdose deaths and potentially inappropriate opioid prescribing practices (PIP)

    Open Access•Thomas J Stopka, Harsha Amaravadi et al.•International Journal of Drug…•2019

  • Worldwide Prevalence and Trends in Unintentional Drug Overdose

    Sílvia S Martins, Laura Sampson et al.•American Journal of Public Health•2015

  • An Examination of Claims-based Predictors of Overdose from a Large Medicaid Program

    Gerald Cochran, Adam J Gordon et al.•Medical Care•2017

  • Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments

    Mark J Pletcher, Stefan G Kertesz et al.•JAMA•2008

  • Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths

    Amy S B Bohnert•JAMA•2011

  • Age and Gender Trends in Long-Term Opioid Analgesic Use for Noncancer Pain

    Cynthia I Campbell, Constance Weisner et al.•American Journal of Public Health•2010

  • Opioid Analgesic Involvement in Drug Abuse Deaths in American Metropolitan Areas

    Leonard J Paulozzi•American Journal of Public Health•2006

Unique citing works6
Citations per year0,55
Citation span2015 - 2019 (5)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 6
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