The University of Pittsburgh reports that inpatient prescription opioids are increasingly being dispensed freely during hospital stays, which may lead to long-term addiction. The study, which was published in the Annals of Internal Medicine, was designed to better understand how, when and with what frequency opioid medication is given to patients in hospitals and whether that influenced use after discharge. 

The study reviewed 191,249 admissions and included a minimum of one patient interview within one year of admission. Researchers measured how many days patients were on opioids and whether prescriptions or self-reporting indicated the continued use of opioids up to one year after leaving the hospital.

The study found a number of trends, including:

  • 48% of patients treated in one of the 12 hospitals in the study were given opioids 
  • Opioids were administered for nearly 70% of the time patients were in inpatient care
  • 5.9% of patients who received opioids continued to use them for at least 90 days after they left the hospital
  • When patients stopped receiving opioids 24 hours before discharge, versus 12 hours before discharge, they had a higher likelihood of continuing to use opioids

Any dynamic that could contribute to opioid abuse is subject to scrutiny by physicians and mental health professionals. The opioid epidemic has claimed the lives of around 700,000 people since 1999 and officials at every level of leadership are eager to see a decline in this trend. 

Physician Opioid Prescription Rates

Opioid prescription statistics reflect significant efforts that have been made in individual states to provide stricter guidelines for opioid prescribing. The Centers for Disease Control (CDC) offers general guidelines for physicians who use opioids for chronic pain, including screening and assessment procedures for addiction risks. 

The number of opioid prescriptions is tracked by the CDC. For 16% of the counties in the United States, there are enough acute opioid prescriptions given to provide opioids to every single person residing in that county. There is some variance between opioids prescribed in hospitals and at traditional doctor visits.

The CDC reports in an evaluation of 31,422 primary care providers in the United States, that physicians averaged opioid prescriptions for 6.9% of their patients per week. Additionally, patients in rural areas had an increased chance of 87% for being prescribed opioids.

In a peer-reviewed study of over one million surgical patients who had not previously used opioids, 56% of them received opioids after surgery. 0.6% of them went on to abuse opioids. The study further indicates that abuse was increased by 44% based on prescription refill, with additional weeks of opioid use continuing to drive up the likelihood of substance abuse or addiction.

Trends also vary for adolescents, with the American Academy of Pediatrics reporting that 14.9% of opioid prescribing was in the context of an emergency medical visit with only 2.8% prescribed in an outpatient setting.

Taking Opioids Home, Often Leads to Long-Term Use

According to the Healthcare Cost and Utilization Project, in 2016, the national rate for hospital stays related to opioid use was 296.9 for every 100,000 people. This may mean that opioid prescription rates impact readmission due to opioid abuse. Prescription opioid use that leads to substance abuse disorder requires more hospitalization.

The prescription opioid epidemic appears to be declining in outpatient care but remains high in a hospital setting, which can lead to abuse.

Preventing Opioid Abuse at the Hospital Level

The Department of Health and Human Services (HHS) declared a public health emergency in 2017 due to high numbers of deaths from prescription opioids. According to statements from the HHS, 11.4 million people abused opioid prescription medications in 2017. One risk factor for prescription opioid abuse is being introduced to opioids in a hospital setting.

The American Hospital Association explains that there are several steps a hospital can take to prevent opioid abuse. These include:

  • Addressing stigma
  • Educating physicians on prescribing practices
  • Alternative, non-opioid pain management
  • Opioid disorder identification and treatment
  • Education for patient families and caregivers
  • Care transition strategies
  • Diversion safeguards
  • Community collaboration

If you or someone you know is struggling with prescription medication abuse, it is important to seek treatment. The Recovery Village can help.