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Descriptive study of prescriptions for opioids from a suburban academic emergency department before New York's I-STOP Act.
West J Emerg Med. 2015 Jan; 16(1):62-6.WJ

Abstract

INTRODUCTION

Controlled prescription opioid use is perceived as a national problem attributed to all specialties. Our objective was to provide a descriptive analysis of prescriptions written for controlled opioids from a database of emergency department (ED) visits prior to the enactment of the I-STOP law, which requires New York prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing Schedule II, III, and IV controlled substances for prescriptions of greater than five days duration.

METHODS

We conducted a retrospective medical record review of patients 21 years of age and older, who presented to the ED between July 1, 2011 - June 30, 2012 and were given a prescription for a controlled opioid. Our primary purpose was to characterize each prescription as to the type of controlled substance, the quantity dispensed, and the duration of the prescription. We also looked at outliers, those patients who received prescriptions for longer than five days.

RESULTS

A total of 9,502 prescriptions were written for opioids out of a total 63,143 prescriptions for 69,500 adult patients. Twenty-six (0.27%) of the prescriptions for controlled opioids were written for greater than five days. Most prescriptions were for five days or less (99.7%, 95% CI [99.6 to 99.8%]).

CONCLUSION

The vast majority of opioid prescriptions in our ED prior to the I-STOP legislature were limited to a five-day or less supply. These new regulations were meant to reduce the ED's contribution to the rise of opioid related morbidity. This study suggests that the emergency physicians' usual prescribing practices were negligibly limited by the new restrictive regulations. The ED may not be primarily contributing to the increase in opioid-related overdoses and death. The effect of the I-STOP regulation on future prescribing patterns in the ED remains to be determined.

Authors+Show Affiliations

Good Samaritan Hospital Medical Center, Department of Emergency Medicine, West Islip, New York.Premier Care Physicians, Department of Emergency Medicine, Bellmore, New York.Good Samaritan Hospital Medical Center, Department of Emergency Medicine, West Islip, New York.New York Colleges of Osteopathic Medicine Educational Consortium, New York, New York ; Touro College of Osteopathic Medicine, Middletown, New York.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25671010

Citation

Ung, Lyncean, et al. "Descriptive Study of Prescriptions for Opioids From a Suburban Academic Emergency Department Before New York's I-STOP Act." The Western Journal of Emergency Medicine, vol. 16, no. 1, 2015, pp. 62-6.
Ung L, Dvorkin R, Sattler S, et al. Descriptive study of prescriptions for opioids from a suburban academic emergency department before New York's I-STOP Act. West J Emerg Med. 2015;16(1):62-6.
Ung, L., Dvorkin, R., Sattler, S., & Yens, D. (2015). Descriptive study of prescriptions for opioids from a suburban academic emergency department before New York's I-STOP Act. The Western Journal of Emergency Medicine, 16(1), 62-6. https://doi.org/10.5811/westjem.2014.12.22669
Ung L, et al. Descriptive Study of Prescriptions for Opioids From a Suburban Academic Emergency Department Before New York's I-STOP Act. West J Emerg Med. 2015;16(1):62-6. PubMed PMID: 25671010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Descriptive study of prescriptions for opioids from a suburban academic emergency department before New York's I-STOP Act. AU - Ung,Lyncean, AU - Dvorkin,Ronald, AU - Sattler,Steven, AU - Yens,David, Y1 - 2015/01/06/ PY - 2014/05/19/received PY - 2014/12/04/accepted PY - 2015/2/12/entrez PY - 2015/2/12/pubmed PY - 2015/11/11/medline SP - 62 EP - 6 JF - The western journal of emergency medicine JO - West J Emerg Med VL - 16 IS - 1 N2 - INTRODUCTION: Controlled prescription opioid use is perceived as a national problem attributed to all specialties. Our objective was to provide a descriptive analysis of prescriptions written for controlled opioids from a database of emergency department (ED) visits prior to the enactment of the I-STOP law, which requires New York prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing Schedule II, III, and IV controlled substances for prescriptions of greater than five days duration. METHODS: We conducted a retrospective medical record review of patients 21 years of age and older, who presented to the ED between July 1, 2011 - June 30, 2012 and were given a prescription for a controlled opioid. Our primary purpose was to characterize each prescription as to the type of controlled substance, the quantity dispensed, and the duration of the prescription. We also looked at outliers, those patients who received prescriptions for longer than five days. RESULTS: A total of 9,502 prescriptions were written for opioids out of a total 63,143 prescriptions for 69,500 adult patients. Twenty-six (0.27%) of the prescriptions for controlled opioids were written for greater than five days. Most prescriptions were for five days or less (99.7%, 95% CI [99.6 to 99.8%]). CONCLUSION: The vast majority of opioid prescriptions in our ED prior to the I-STOP legislature were limited to a five-day or less supply. These new regulations were meant to reduce the ED's contribution to the rise of opioid related morbidity. This study suggests that the emergency physicians' usual prescribing practices were negligibly limited by the new restrictive regulations. The ED may not be primarily contributing to the increase in opioid-related overdoses and death. The effect of the I-STOP regulation on future prescribing patterns in the ED remains to be determined. SN - 1936-9018 UR - https://www.unboundmedicine.com/medline/citation/25671010/Descriptive_study_of_prescriptions_for_opioids_from_a_suburban_academic_emergency_department_before_New_York's_I_STOP_Act_ L2 - http://escholarship.org/uc/item/1362p53p DB - PRIME DP - Unbound Medicine ER -