Trends in emergency physician opioid prescribing practices during the United States opioid crisis.
BACKGROUND
Prescription opioid related deaths have increased dramatically over the past 17 years. Although emergency physicians (EPs) have not been the primary force behind this rise, previous literature have suggested that EPs could improve their opioid prescribing practices. We designed this study to evaluate the trend in emergency department (ED) opioid prescriptions over time during the US opioid epidemic.


METHODS
We conducted a retrospective cohort study from July 1, 2012 to June 30, 2018, evaluating all adult patients who presented to two study EDs for a pain-related complaint and received an analgesic prescription upon ED discharge. We compared these data to trends in lay media and medical literature regarding the opioid epidemic. We also evaluated the incidence of repeat ED visits based on the type of analgesic prescriptions provided.


RESULTS
Opioid prescriptions decreased from 37.76% to 13.29% over the six year study period. This coupled with an increase in non-opioid medications from 6.12% to 11.33% and an increase in "no prescription" from 56.12% to 75.37%. This corresponded with an increase in the number of publications on the opioid epidemic within the lay-public and medical literature. Additionally, those patients that received no opiates were less likely to require a repeat ED visit.


CONCLUSIONS
ED physicians are prescribing less opiates, while increasing the amount of non-narcotic analgesic prescriptions. This may be in response to the literature suggesting that prescription opioids play a large role in the opioids crisis. This decrease in opioid prescriptions did not increase the need for repeat ED visits.
['Gleber|Ryan|R|', 'Vilke|Gary M|GM|', 'Castillo|Edward M|EM|', 'Brennan|Jesse|J|', 'Oyama|Leslie|L|', 'Coyne|Christopher J|CJ|']
D000328:Adult D000368:Aged D000701:Analgesics, Opioid D015331:Cohort Studies D011307:Drug Prescriptions D004635:Emergency Medicine D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D000080052:Opioid Epidemic D010818:Practice Patterns, Physicians' D012189:Retrospective Studies D014481:United States
Opioid crisis Addition Analgesia Opiate crisis Prescription drugs