ER Patients Left in the Dark About Risks for Opioid Painkiller Addiction

Posted on July 22nd, 2015

ER Patients Left in the Dark About Risks for Opioid Painkiller AddictionPeople receiving medical treatment in U.S. emergency rooms often have an incomplete or inaccurate understanding of the dependence and addiction risks associated with the use of opioid painkillers, according to new findings from a group of American researchers.

Opioid medications are commonly used in America’s emergency rooms during treatment for broken bones and other serious injuries. Unfortunately, consumption of these medications can sometimes lead to the development of an opioid addiction. In a study published in April 2015 in the Annals of Emergency Medicine, researchers from two branches of the University of Pennsylvania used a small-scale project to estimate the average ER patient’s level of awareness regarding opioid-related risk. These researchers concluded that recipients of opioid medications often don’t receive adequate information from their physicians and rely on non-medical resources for their knowledge of the chances of developing opioid problems.

Opioids in the Emergency Room

All opioid medications produce their pain-relieving effect by altering the brain’s ability to perceive or accurately interpret pain signals sent from nerves in various parts of the body. Specific examples of these medications used in an emergency room setting include codeine, oxycodone (the active ingredient in products such as Percocet and Percodan), hydrocodone (the active ingredient in a product called Zohydro ER), morphine, meperidine and hydromorphone. Some of these substances come directly from materials that naturally occur in the opium poppy (the ultimate source for all opioid drugs and medications), while others are synthetic variations of naturally occurring opioids.

In a study published in 2014 in the journal Academic Emergency Medicine, a team of U.S. researchers examined the rate of opioid medication use in America’s emergency rooms in the first decade of the 21st century. These researchers concluded that the rate of opioid use increased by roughly 10 percent during the period under consideration, while the rate of ER visits requiring pain-related treatment increased by only 3 percent over the same span of time. Emergency room personnel use hydrocodone more than any other opioid medication. Meperidine and oxycodone are the next most likely opioid treatment options. However, between 2001 and 2010, opioid medications with the highest increase in usage rates were morphine and hydromorphone.

Opioid Dependence and Addiction

Opioid dependence occurs when an opioid consumer undergoes lasting changes in brain function that make him or her reliant on continuing opioid use in order to feel “normal.” However, opioid dependence is not the same thing as opioid addiction. A person can develop a dependence on opioids even when he or she strictly follows the dosing instructions issued by a doctor. As a rule, doctors can limit or eliminate any dependence-related risks through proper patient oversight and management. In contrast, a person addicted to opioid use has an uncontrolled pattern of excessive opioid consumption that substantially damages his or her ability to function and maintain a productive daily routine. Risks for a transition from opioid dependence to opioid addiction are typically highest in people who misuse a prescribed opioid, consume an opioid medication without a prescription or consume an opioid drug.

Do ER Patients Understand the Risks?

In the study published in the Annals of Emergency Medicine, the University of Pennsylvania researchers used detailed interviews with 23 adults to help determine if people receiving opioid-based treatment in emergency rooms understand the risks associated with consuming these medications. These participants were treated for highly painful conditions that included broken bones, spinal muscle damage and kidney stones.

After completing the interviews, the researchers concluded that doctors in emergency rooms commonly fail to explain the dependence/addiction risks associated with the use of opioid medications. ER doctors also commonly fail to inform their patients about appropriate non-opioid treatment options. As a result of a lack of information from their physicians, ER patients often turn to alternate (and often inaccurate) sources of information, such as TV portrayals and the opinions of their friends or families.

Tellingly, the researchers found that most ER patients don’t realize that they can become dependent on opioid medications (and thereby expose themselves to addiction) even when those medications are used according to their doctors’ instructions. Patients who feel unsatisfied with their pain-related treatment share factors that include poor quality of interaction with their doctors, lack of understanding about what’s happening to them and a fragmented treatment approach that relies on the contributions of multiple professionals rather than a single physician.

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