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The Declining Use of Opioids at a Level 1 Trauma Center.

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Inpatient opioid administration decreased significantly in trauma patients, even without specific prescribing restrictions. This study observed a 28% drop in opioid use among hospitalized trauma patients between 2016 and 2020.

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Area of Science:

  • Trauma Surgery
  • Pain Management
  • Public Health Policy

Background:

  • The opioid overdose epidemic led to prescribing guidelines, but these did not apply to hospitalized trauma patients.
  • This study investigated opioid administration trends in trauma patients despite the absence of specific in-hospital prescribing mandates.

Purpose of the Study:

  • To determine if inpatient opioid administration decreased over time in hospitalized trauma patients.
  • To analyze trends in opioid administration and dosage (MME) in trauma patients from 2016 to 2020.

Main Methods:

  • Retrospective analysis of opioid administrations for trauma patients from January 2016 to July 2020.
  • Opioid administrations were converted to oral morphine milligram equivalents (MMEs) and analyzed using general linear models.
  • Patients who were pregnant or mechanically ventilated were excluded from the analysis.

Main Results:

  • Opioid administration decreased from 79.3% in 2016 to 71.4% in 2020.
  • Average total MMEs decreased by 28% from 2016 to 2020.
  • Opioid MMEs trended downward over time across all injury severity scores (ISS).

Conclusions:

  • A stepwise reduction in opioid administration was achieved in this trauma center.
  • Significant decreases in opioid use occurred without specific in-hospital prescribing rules.