Even although a sprained ankle not often wants an opioid, a brand new research of emergency room sufferers discovered that about 7 p.c of sufferers acquired despatched house with a prescription for the doubtless addictive painkiller anyway. And the extra drugs prescribed, the higher the prospect the prescription can be refilled, elevating issues about continued use.
The analysis provides to proof that it’s onerous for some people to cease taking the drugs even after a short use. State officers in New Jersey lately enacted a regulation limiting first-time prescriptions to a five-day provide, and different states ought to think about comparable restrictions, says Kit Delgado, an assistant professor of Emergency Medicine and Epidemiology on the University of Pennsylvania.
“The bottom line is that we need to do our best not to expose people to opioids,” Delgado says. “And if we do, start with the smallest quantity possible.” The analysis was offered May 17 on the Society for Academic Emergency Medicine’s annual assembly in Orlando.
Previous analysis has discovered that the extra opioids equivalent to hydrocodone and oxycodone are prescribed, the extra possible sufferers are to maintain taking them. But earlier research have been too broad to account for variations in diagnoses — for occasion, whether or not people who obtained refills stored taking the drug just because they nonetheless had been in ache, Delgado says. He and colleagues restricted their research to prescriptions written after ankle sprains to people who had not used an opioid within the earlier six months. Usually, these accidents aren’t severe and don’t require opioids.
About 7 p.c of 53,222 people who visited ERs with ankle sprains in 2011 and 2012 had been despatched house with an opioid prescription, the researchers discovered. Patients’ experiences different by state: Less than 2 p.c handled in Delaware had been prescribed an opioid in contrast with 16 p.c in Mississippi.
The variety of drugs obtained inside every week of these visits additionally different significantly, from as few as 5 to greater than 60. Typical prescriptions had been for 15 to 40 drugs. Those who obtained prescriptions for 30 drugs or extra had been twice as prone to get refills as these with prescriptions for 15 or fewer, Delgado and colleagues discovered.
“Because these are patients who have a uniformly minor injury, it emphasizes how much arbitrariness there is in how physicians prescribe opioids,” says Michael Barnett, an emergency doctor at Brigham and Women’s Hospital in Boston, who was not concerned within the research.
In February, Barnett and colleagues revealed a research of ER opioid prescribing within the New England Journal of Medicine, which discovered that higher exposures carry greater odds of long-term use. The power of the brand new research, he stated, is that “an ankle sprain is an ankle sprain. It’s a minor injury that requires very little treatment beyond rest, ice and elevation.”