Low Quantity of Opioids Used After ED Discharge for Acute Pain

For patients presenting with acute pain, the quantity of opioids consumed during two weeks after emergency department discharge is low and varies across pain conditions, according to a study published online July 15 in CMAJ, the journal of the Canadian Medical Association.

Raoul Daoust, M.D., from Sacré-Coeur Hospital in Montreal, and colleagues conducted a prospective, multicenter cohort study involving 2,240 adults (mean age, 51 years) with an acute pain condition present for less than two weeks who were discharged from the emergency department with an opioid prescription. Participants completed a pain medication diary for real-time recording of all analgesics consumed during a 14-day follow-up.

The researchers found that participants consumed a median of five morphine 5-mg tablet equivalents over 14 days, with significant variation seen across pain conditions. Overall, 63 percent of the opioid tablets prescribed were unused. Those experiencing renal colic or abdominal pain required fewer opioid tablets (eight morphine 5-mg tablet equivalents) than those with fractures, back pain, neck pain, or other musculoskeletal pain (24, 21, 17, and 16 tablets, respectively) to meet the opioid need of 80 percent of patients for two weeks.

"Our findings may provide guidance to enable clinicians to prescribe lower quantities of opioids and provide them in even smaller portions tailored to the specific cause of acute pain, thereby allowing adequate pain relief while reducing the risk of opioid misuse," the authors write.

One author disclosed ties to the medical device industry.