Summary: Many patients experiencing severe pain are not administered opioids even when other medications fail to help. One of the new studies shows that when opioids are administered in an emergency care setting to opioid naïve patients, it does not pose an addiction risk.
Not every kind of opioid use poses an addiction risk. This is especially important to understand, as an increasing number of voices are being raised to reduce opioid use in clinical practice. However, reducing opioid use or discontinuing opioids in all clinical scenarios may do more harm than good.
Opioids are among the most potent pain relievers. They are exceptionally good for managing moderate to severe pain. Opioids are equally suitable for managing acute and chronic pain.
Unlike in chronic health issues, when opioids are used for managing acute pain, they are less likely to cause addiction or even other harm. This is because, when they are used to manage acute pain, their use is not prolonged.
For example, opioids may provide excellent relief to a person with a broken leg or arm or in other kinds of traumas. These drugs are really good for use in emergency medicine. Moreover, in emergency medicine, these drugs are injected under medical supervision, and thus, they rarely cause any severe side effects.
However, in the last few years, opioid use in various clinical scenarios has declined. This is because many believe that even short-term use of opioids may cause addiction and other harms. However, one of the new studies shows that these concerns are ill-founded. The use of opioids in emergency rooms is unlikely to cause addiction.
This new study was published in The Journal of Emergency Medicine. In the study, researchers screened 1555 patients. In the final study, 506 patients were included. These were patients who were administered opioids in the emergency room. Some of the commonly used opioids were hydromorphone and morphine.
In the study, researchers followed these patients for 6 months after their last visit to the emergency department or opioid use. They found that at 6 months, just one of those patients was persistently using opioids. Hence, it would be right to say that the risk of addiction to opioids when they are used in an emergency room is close to 0% or nil.
Here, it is also worth noticing that these were opioid naïve patients. It means that they had no prior experience of opioid use. They received their first opioid injection in an emergency care setting. This study confirms that when opioids are administered in such settings, they do not pose any risk of addiction.
Moreover, researchers further noticed that after treatment in the emergency room, 63 of the patients were even given opioid prescriptions on discharge. However, all of them discontinued opioid use after their recovery, and only one of the patients continued opioid use at 6 months. This highlights that Opioid Addiction treatment is rarely needed when opioids are used responsibly in emergency settings, as the risk of addiction is minimal.
Researchers say that one should still use opioids with extreme care and only when there are strong clinical indications, like severe pain uncontrolled by other painkillers like acetaminophen. However, they also say that their study shows that when opioids are used carefully, they are safe, helpful, and do not cause addiction.
There is some sound data that many patients are being refused parental opioids, even when they are experiencing severe pain, a pain that other drugs could not control, which means that excessive precaution or worries regarding the side effects of opioids are causing more harm than good.
Of course, this is not the first study in this direction. Previous studies have also shown that the chances of opioid addiction are really low when they are used in emergency settings and in patients.
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
