Potentially Inappropriate Use of Intravenous Opioids in Hospitalized Patients

Physicians have the potential to decrease opioid misuse through appropriate prescribing practices. We examined the frequency of potentially inappropriate intravenous (IV) opioid use (where oral use would have been more appropriate) in patients hospitalized at a tertiary medical center. We excluded patients with cancer, patients receiving comfort care, and patients with gastrointestinal dysfunction. On the basis of recent guidance from the Society of Hospital Medicine, we defined IV doses as potentially inappropriate if administered more than 24 hours after an initial IV dose in patients who did not have nil per os status. Of the 200 patients studied, 31% were administered potentially inappropriate IV opioids at least once during their hospitalization, and 33% of all IV doses administered were potentially inappropriate. Given the numerous advantages of oral over IV opioids, this study suggests significant potential for improving prescribing practices to decrease risk of addiction, costs, and complications, ultimately improving the value of care provided.