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The Contribution of the Emergency Department To Opioid Pain Reliever Misuse And Diversion: A Critical Review
Author(s) -
Lyapustina Tatyana,
Castillo Renan,
Omaki Elise,
Shields Wendy,
McDonald Eileen,
Rothman Richard,
Gielen Andrea
Publication year - 2017
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12568
Subject(s) - medicine , medical prescription , emergency department , opioid , psychological intervention , pill , medical emergency , family medicine , psychiatry , nursing , receptor
Prescription opioid pain reliever ( OPR ) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPR s, yet the relative contribution of emergency department ( ED ) OPR prescriptions to the overall opioid abuse epidemic remains unclear. This study critically reviews seven peer‐reviewed studies that specifically identified the ED as a source of OPR s. Of the OPR s prescribed in the ED , approximately 10% are associated with indicators of inappropriate prescribing, and approximately 42% may ultimately be misused; of the OPR s that are diverted, approximately 10% originate from an ED prescription. Among patients who suffer an OPR ‐related death, approximately 1.8% of the OPR pills given to the decedents will have come from the ED . In addition to the need for more research, the existing literature suggests an urgent need for interventions in the ED to reduce OPR misuse and diversion.