Linking emergency department opioid prescribing with ongoing opioid use: a statewide data linkage study

Chronic opioid use can develop in previously opioid-naïve patients following an emergency department (ED) or hospital admission; however, most evidence is from North America. This study aims to assess the prevalence of persistent opioid use after an ED presentation in an Australian setting.

This was a population-based, retrospective cohort study using state-based linked data. Persistent opioid use was defined as continued use after 12 months, among previously opioid-naïve patients who filled an opioid prescription following discharge from any Queensland public hospital ED between 1 January 2011 and 31 December 2017. Descriptive statistics were used to summarise demographic characteristics of the study population and to outline primary outcome measures.

There were 3,082,681 ED presentations during the study period, and 11,281,039 opioid prescriptions within 12 months of the ED presentations included in the study. A total of 186,545 opioid-naïve patients had an opioid prescription associated with their ED presentation, with more prescriptions in 2017 (34,273) compared with 2011 (14,896), driven predominantly by oxycodone prescription increases. However, of the total cohort, only 3539 (1.9%) were classified as persistent opioid users, with similar annual proportions seen throughout the study period.

The proportion of patients progressing to persistent opioid use after ED presentation was low and remained relatively stable, despite a substantial increase in the number of patients receiving at least one opioid prescription after an ED presentation. These results highlight the need for continued focus on appropriate prescribing and patient safety.