Researchers identify risk factors for ER visits in chronic opioid users

Use of Schedule II opioids, back pain, headache, and pre-existing substance use disorders are all associated with alcohol- or drug-related encounters (ADEs) and emergency department visits (EDVs) in adults who have taken prescribed opioids for at least 90 days, according to a study published in the Sept. 13 issue of the Archives of Internal Medicine, HealthDay News reports.

Jennifer Brennan Braden, MD, of the University of Washington School of Medicine and colleagues analyzed data on the use of prescription opioids for at least 90 continuous days by adults with no cancer diagnosis. They used regression analysis to look for risk factors for EDVs and ADEs within 12 months of opioid use. Study participants had Arkansas Medicaid or HealthCore (commercial) insurance.

Researchers found a significant association between EDVs and ADEs and pre-existing substance use disorders, headache, and back pain, and mental health problems were associated with EDVs in individuals enrolled in HealthCore and with ADEs in both HealthCore and Medicaid enrollees.

Daily opioid use greater than 120 mg/d (morphine-equivalent) doubled the risk of ADEs, though daily opioid dose was not consistently linked to EDVs. Use of short-acting Drug Enforcement Agency Schedule II opioids was associated with EDVs, and use of Schedule II long-acting opioids was associated with ADEs.