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Use of opioids and analgesics among ED patients with dental and low back pain: A national perspective.
Am J Emerg Med. 2019 Jun; 37(6):1085-1090.AJ

Abstract

OBJECTIVES

Emergency department (ED) visits for dental pain and low back pain (LBP) are common. Many such patients have severe pain and receive opioids. Increased opioid-related deaths has led to efforts to reduce opioid prescriptions. We compared recent trends in use of analgesics and opioids in the ED and at discharge among patients with dental or LBP.

METHODS

We conducted a secondary analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) of patients with dental pain or LBP from 2010 to 2015. We performed univariate and multivariate analyses exploring the association between pain location and use of analgesics and opioids controlling for age, gender, and pain severity.

RESULTS

There were an estimated 16 and 49 million patient visits for dental and LBP, respectively. Prescription of opioids at discharge decreased from 59% to 50% (p = 0.02) in dental and 46% to 39% in LBP patients (p = 0.09). Compared to patients with LBP, patients with dental pain were less likely to receive analgesics (OR 0.65, 95% CI, 0.57-0.74) or opioids (OR 0.51, 95% CI, 0.44-0.59) while in the ED. In contrast, dental pain patients were more likely to have analgesics (OR 1.32, 95% CI, 1.16-1.51) or opioids (OR 1.65, 95% CI, 1.47-1.85) prescribed at the time of ED discharge than patients with LBP.

CONCLUSIONS

Prescription of opioids decreased for ED dental patients. While less likely to receive analgesics and opioids in the ED, patients with dental pain were more likely to be prescribed analgesics and opioids at the time of ED discharge than those with LBP.

Authors+Show Affiliations

The Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, United States of America.The Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, United States of America.The Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, United States of America. Electronic address: adam.singer@stonybrook.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30177267

Citation

Morris, Mathew, et al. "Use of Opioids and Analgesics Among ED Patients With Dental and Low Back Pain: a National Perspective." The American Journal of Emergency Medicine, vol. 37, no. 6, 2019, pp. 1085-1090.
Morris M, Thode HC, Singer AJ. Use of opioids and analgesics among ED patients with dental and low back pain: A national perspective. Am J Emerg Med. 2019;37(6):1085-1090.
Morris, M., Thode, H. C., & Singer, A. J. (2019). Use of opioids and analgesics among ED patients with dental and low back pain: A national perspective. The American Journal of Emergency Medicine, 37(6), 1085-1090. https://doi.org/10.1016/j.ajem.2018.08.062
Morris M, Thode HC, Singer AJ. Use of Opioids and Analgesics Among ED Patients With Dental and Low Back Pain: a National Perspective. Am J Emerg Med. 2019;37(6):1085-1090. PubMed PMID: 30177267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of opioids and analgesics among ED patients with dental and low back pain: A national perspective. AU - Morris,Mathew, AU - Thode,Henry C,Jr AU - Singer,Adam J, Y1 - 2018/08/24/ PY - 2018/07/09/received PY - 2018/08/21/revised PY - 2018/08/23/accepted PY - 2018/9/5/pubmed PY - 2020/1/30/medline PY - 2018/9/5/entrez SP - 1085 EP - 1090 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 37 IS - 6 N2 - OBJECTIVES: Emergency department (ED) visits for dental pain and low back pain (LBP) are common. Many such patients have severe pain and receive opioids. Increased opioid-related deaths has led to efforts to reduce opioid prescriptions. We compared recent trends in use of analgesics and opioids in the ED and at discharge among patients with dental or LBP. METHODS: We conducted a secondary analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) of patients with dental pain or LBP from 2010 to 2015. We performed univariate and multivariate analyses exploring the association between pain location and use of analgesics and opioids controlling for age, gender, and pain severity. RESULTS: There were an estimated 16 and 49 million patient visits for dental and LBP, respectively. Prescription of opioids at discharge decreased from 59% to 50% (p = 0.02) in dental and 46% to 39% in LBP patients (p = 0.09). Compared to patients with LBP, patients with dental pain were less likely to receive analgesics (OR 0.65, 95% CI, 0.57-0.74) or opioids (OR 0.51, 95% CI, 0.44-0.59) while in the ED. In contrast, dental pain patients were more likely to have analgesics (OR 1.32, 95% CI, 1.16-1.51) or opioids (OR 1.65, 95% CI, 1.47-1.85) prescribed at the time of ED discharge than patients with LBP. CONCLUSIONS: Prescription of opioids decreased for ED dental patients. While less likely to receive analgesics and opioids in the ED, patients with dental pain were more likely to be prescribed analgesics and opioids at the time of ED discharge than those with LBP. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/30177267/Use_of_opioids_and_analgesics_among_ED_patients_with_dental_and_low_back_pain:_A_national_perspective_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(18)30713-7 DB - PRIME DP - Unbound Medicine ER -