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Patterns of opioid use for lower limb trauma patients during the first 6 months after discharge

05 December 2024
Professional
02 December 2024
Volume 33 · Issue 22

Abstract

Guidance recommends that prescribed opioids for acute pain should not be continued beyond the expected period of healing and may lead to long-term use if a large supply is provided or repeat prescriptions are requested. This project investigated how opioids are used by opioid-naïve trauma patients in the first 6 months following discharge from hospital. The findings indicate that patients are frequently discharged from hospital with an opioid prescription and for some this will continue beyond the recommended maximum duration of 3 months and will include dose escalation. Clinicians should be aware of the potential risks associated with prolonged opioid use, including the increased risk of accidental overdose and potential death, and be able to identify which patients are at most risk. Screening for indicators for long-term use may prove more useful than formal risk stratification tools in an acute pain population.

In the past few years there has been mounting concern over the increasing use of prescribed opioid medicines. Prescribed opioids are defined as those used to treat pain in the way intended by the prescriber (Whiteside et al, 2016). Opioids are a commonly recognised cause of adverse effects in hospital, including opioid-induced ventilatory impairment and sedation, but are now associated with a concerning rise in the more serious events such as misuse, prolonged use and death associated with the increased use of prescription opioids beyond discharge from hospital (Macintyre et al, 2014). In 2017-2018 13% of the adult population of the UK had received one or more prescriptions for opioids, and approximately half were estimated to have been receiving a prescription continuously for at least 12 months (Taylor et al, 2019). These figures are for all patients receiving opioid prescriptions, and will therefore include those taking them for acute, persistent, and palliative pain.

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Opioid
Acute pain
Opioid risk stratification
Persistent postoperative opioid use
Discharge medications