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Opioid Overdose Risk in Patients Returning to the Emergency Department for Pain
Sophia Sheikh1, Ashley Booth-Norse1, David Holden1
1University of Florida College of Medicine-Jacksonville, Jacksonville, Florida.
Pain Medicine (Malden, Mass.)
|February 9, 2021
Summary
The Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) identified a high opioid overdose risk in 25% of patients discharged from the ED. This tool can help stratify risk for patients prescribed opioids.
Area of Science:
- Emergency Medicine
- Pharmacology
- Public Health
Background:
- Opioid prescriptions following emergency department (ED) visits for pain are common.
- Assessing overdose risk in patients discharged with opioids is crucial for patient safety.
- Opioid-naive patients may have different risk profiles compared to those with prior opioid exposure.
Purpose of the Study:
- To evaluate the overall opioid overdose risk in patients returning to the ED for pain and discharged with an opioid prescription.
- To compare the overdose risk between opioid-naive and non-opioid-naive patients using the CIP-RIOSORD.
- To assess the utility of the CIP-RIOSORD in stratifying overdose risk in this patient population.
Main Methods:
- Secondary analysis of a prospective observational study involving patients aged 18+ returning to the ED within 30 days.
- Patients were categorized into two groups: opioid-naive (Group 1) and non-opioid-naive (Group 2).
- The Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) was used to determine risk class and probability of overdose.
Main Results:
- Of 389 patients returning to the ED, 67 were prescribed opioids; 60% were opioid-naive.
- Both groups had an average CIP-RIOSORD risk class of 3; however, non-opioid-naive patients had nearly double the predictive factors.
- Race differed significantly between groups, with a higher proportion of African Americans in the opioid-naive group.
Conclusions:
- A significant proportion (25%) of patients discharged with opioid prescriptions from the ED were identified as high risk for overdose.
- The CIP-RIOSORD demonstrates potential utility in the risk stratification of patients receiving opioid prescriptions from the ED.
- Further research may refine risk assessment tools for safe opioid prescribing practices.
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