Researchers found that 48% of patients who had never before had opioids were given opioids during their hospital admission.
While the medical community has rethought outpatient opioid use in recent years and drastically reduced prescriptions, little has changed in the way that opioids are prescribed to patients in a hospital setting.
Now, a new study indicates that receiving opioids even in a hospital setting can increase a patient’s risk of long-term opioid use.
The study, published in the journal Annals of Internal Medicine, found that prescribing opioids is still extremely common for hospitalized patients.
“I was surprised by the level of opioid prescribing to patients without a history of opioid use,” lead author Julie Donohue, professor in Pitt Public Health’s Department of Health Policy and Management, told Science Daily. “About half of the people admitted to the hospital for a wide variety of medical conditions were given opioids. The stability of this prescribing also was surprising. Nationally and regionally, as people have become more aware of how addictive opioids can be, we’ve seen declines in outpatient opioid prescribing. But we didn’t see that in inpatient prescribing.”
In fact, researchers found that 48% of patients who had never before had opioids were given opioids during their hospital admission.
The study, which looked at 191,249 hospitalizations between 2010 and 2014, found that people who were prescribed opioids for the first time in an inpatient setting were twice as likely to still be using opioids three months after they were discharged, compared with those who did not receive opioids in the hospital.
The time when people were given opioids also made a difference in their long-term use of the drugs. Only 3.9% of people who had no opioids for 24 hours before their discharge were still using opioids three months later. By comparison, 7.5% of patients who took opioids within 12 hours of discharge reported long-term use.
The study also found that opioids were often the first line response to pain. Less dangerous options like over-the-counter painkillers were given first only 8% of the time, researchers found.
“Inpatient opioid use has been something of a black box,” Donohue said. “And, while our study could not assess the appropriateness of opioid administration, we identified several practices—low use of non-opioid painkillers, continuous use of opioids while hospitalized, opioid use shortly before discharge—which may be opportunities to reduce risk of outpatient opioid use and warrant further study.”
Another recent study found that about half of patients who underwent surgery were able to manage their pain without opioids, using just over-the-counter painkillers. Research like that indicates that opioids are likely unnecessary for some patients who receive them, even in a hospital setting.