Opioid prescriptions in emergency departments: Findings from the 2016 National Hospital Ambulatory Medical Care Survey

Abstract

In the past decade, there has been a rising trend in the emergency department (ED) visits in the US and these visits carry a significant burden of prescription opioids. This study utilized the latest available data from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS) and examined the factors associated with opioid prescriptions in the ED. The outcome variable was receipt of opioid prescription, and the primary variable of interest was the type of visit (dental/non-dental). Other variables included age, gender, race/ethnicity, region, payer, day of the visit, and pain level. Descriptive and multivariate analyses were conducted and predicted marginal probabilities were determined. P ≤ 0.05 was considered statistically significant. In 2016, 22.5% of visits in ER received opioid prescriptions. In the unadjusted analysis, opioid prescriptions were associated with all correlates except day of the visit. In the adjusted model, odds of receiving opioid prescription were 3.5 times more among dental visits compared to non-dental visits (95% Confidence Interval [CI] = 2.4–5.1) and 9.4 times more among visits with severe pain compared to visits with mild pain (95% CI = 7.7–11.4). Opioid prescriptions among 45–64 years old were 7.1 times (95% CI = 5.5–9.1] more likely compared to those among under 18 age-group. Opioid prescriptions in ED differed significantly by the type of visit and pain level. Given the higher likelihood of opioid prescriptions among dental visits, it is imperative to develop better prescription guidelines for dental visits in ED.