Emergency department doctors should limit the extent of opioid prescriptions given to patients who are being discharged after injury, a European conference has been told.
Half of patients discharged from the emergency department should be given only five or fewer 5 mg tablets of morphine or an equivalent opioid pain killer.
Canadian research, presented at the European Emergency Medicine Congress), in Barcelona, Spain, yesterday says while it is vital that patients are given sufficient medication to help them recover from pain and injury, the balance has to be right.
The recent crisis in opioid abuse has been partly attributed to over-prescription, particularly for chronic pain, and doctors have become cautious about giving these drugs to patients.
Professor Raoul Daoust, from the University of Montreal, said: “Opioids such as morphine can be very beneficial for patients suffering acute pain, for example when they have injured their neck or broken a bone. However, patients are often prescribed too many opioid tablets and that means unused tablets are available for misuse. On the other hand, since the opioid crisis, the tendency in the USA is to not prescribe opioids at all, leaving some patient in agonising pain.
“With this research I wanted to provide a tailored approach to prescribing opioids so that patients have enough to manage their pain but almost no unused tablets available for misuse.”
Prof Daoust and his colleagues recruited 2,240 adult patients who were treated at one of six hospital emergency departments in Canada for a condition that causes acute pain.
All were discharged with an opioid prescription and were asked to complete a pain medication diary for the following two weeks.
Half of patients took five 5mg morphine tablets or fewer.
Prof Daoust said: “We found that, in general, patients consume few opioids, but this varies depending on the type of painful condition. Our findings make it possible to adapt the quantity of opioids we prescribe according to patient need. We could ask the pharmacist to also provide opioids in small portions, such as five tablets initially, because for half of patients that would be enough to last them for two weeks.”
The research team hopes to apply their results in the clinic to evaluate the impact on long-term use and misuse.
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