Prescribing opioids in the ER less likely to result in long-term use

A new study, published in the Annals of Emergency Medicine, examined opioid prescription patterns in emergency and non-emergency settings.

Researchers analyzed 5.2 million prescriptions for opioids given out in emergency rooms and other medical settings.

The study shows opioid prescriptions exceeding seven days were 84 to 91 percent lower in the ER as compared to non-emergency settings.

Additionally, compared to non-emergency settings, opioid prescriptions in the ER were:

●    33 to 37 percent less likely to exceed 50 morphine milligram equivalents
●    33 to 54 percent less likely to exceed 90 milligram equivalents
●    86 to 92 percent less likely to be written for long-acting or extended-release formulations

Researchers also found patients receiving opioid prescriptions in the ER were less likely to progress to long-term opioid use. Specifically, commercial insurance patients were 46 percent less likely; Medicare patients were 56 percent less likely; and patients with disabled Medicare were 58 percent less likely to progress to long-term use if they received opioid prescriptions in the ER.

"Our paper lays to rest the notion that emergency physicians are handing out opioids like candy," said Molly Moore Jeffery, PhD, lead study author and scientific director of the Mayo Clinic Division of Emergency Medicine Research in Rochester, Minn. "Close adherence to prescribing guidelines may help explain why the progression to long-term opioid use is so much lower in the ER. Most opioid prescriptions written in the emergency department are for shorter duration, written for lower daily doses and less likely to be for long-acting formulations."

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