ER-prescribed opioids are unlikely to cause addiction in patients who have not taken opioids before, a new study found. Giving opioids for severe pain in the emergency room did not raise addiction risk. Yet many ER patients in severe pain still go without them when other medicines fail.
Summary: Many patients in severe pain are not given opioids, even when other medicines fail. A new study shows that opioids given in emergency care to patients who have never taken them do not pose an addiction risk.
Not every kind of opioid use carries an addiction risk. That matters, because more and more voices are calling to cut opioid use in medical practice. But cutting or stopping opioids in every situation may do more harm than good.
Opioids are among the strongest pain relievers. They are very good for moderate to severe pain. They work well for both sudden pain and long-term pain.
When opioids are used for sudden pain, they are less likely to cause addiction or other harm than in long-term conditions. That is because their use for sudden pain is short.
For example, opioids can bring excellent relief to a person with a broken leg or arm, or other injuries. These drugs are very good for emergency medicine. In emergency care, they are also injected under medical supervision. So they rarely cause any severe side effects.
But in the last few years, opioid use has dropped across many medical settings. That is because many people believe even short-term opioid use may cause addiction and other harm. A new study shows these worries are unfounded. Opioids used in emergency rooms are unlikely to cause addiction.
This new study was published in The Journal of Emergency Medicine. Researchers screened 1555 patients. The final study included 506 patients. All were given opioids in the emergency room. Common opioids used were hydromorphone and morphine.
Researchers followed these patients for 6 months after their last ER visit or opioid use. At 6 months, just one of them was still using opioids steadily. So it is fair to say the risk of addiction from opioids used in an emergency room is close to 0% or nil.
It is also worth noting these patients had never taken opioids before. Their first opioid shot came in emergency care. This study confirms that opioids given in such settings carry no addiction risk.
Researchers also noticed that 63 of the patients were given opioid prescriptions when they left the emergency room. All of them stopped using opioids once they recovered, and only one patient was still using opioids at 6 months. So opioid addiction treatment is rarely needed when opioids are used responsibly in emergency care, because the addiction risk is very small.
Researchers say opioids should still be used with great care, and only for strong medical reasons. One example is severe pain that other painkillers like acetaminophen cannot control. But they also say their study shows that opioids used carefully are safe, helpful and do not cause addiction.
There is solid data that many patients are refused IV opioids even when they are in severe pain that other drugs could not control. That means too much caution, or too much worry about side effects, is causing more harm than good.
Of course, this is not the first study to point this way. Earlier studies also showed the chance of opioid addiction is very low when opioids are used in emergency care.
Frequently asked questions
Are opioids given in the ER addictive?
Not for patients who have never taken opioids, according to a study in The Journal of Emergency Medicine. Researchers followed 506 patients who got IV opioids such as hydromorphone and morphine in the emergency room. Six months later, only one of them was still using opioids steadily. That puts the addiction risk from ER opioids close to zero.
Can a short course of opioids after an injury lead to addiction?
Rarely. For sudden pain, such as a broken arm or leg, opioid use is short. So it is far less likely to cause addiction than long-term use for chronic conditions. In the study, 63 patients also went home with an opioid prescription, and they stopped once they recovered. Only one patient in the whole study was still using opioids at six months.
Why are some ER patients in severe pain not given opioids?
Many doctors believe even short-term opioid use can cause addiction. So opioid use has dropped across medical settings. As a result, some patients are refused IV opioids even when other drugs cannot control their pain. This study shows that worry is unfounded for ER patients who have never taken opioids. Too much caution is causing more harm than good.
Source:
Irizarry, E., Cho, R., Williams, A., Davitt, M., Baer, J., Campbell, C., Cortijo-Brown, A., & Friedman, B. W. (2024). Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study. The Journal of Emergency Medicine, 67(2), e119–e127. https://doi.org/10.1016/j.jemermed.2024.03.018
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