Opioid-related adverse drug reactions in patients visiting the emergency division of a tertiary hospital

Pharmacol Res Perspect. 2022 Dec;10(6):e01033. doi: 10.1002/prp2.1033.

Abstract

Opioid use and associated morbidity and mortality have increased in several countries during the past 20 years. We performed a study whose objective was to assess the frequency and causes of opioid-related emergency division (ED) visits in an adult tertiary Swiss University Hospital over 9 weeks in 2018. We primarily assessed opioid-related adverse drug reactions (ADR), secondary overdose, misuse, abuse, and insufficient pain relief. Current opioid use was identified in 1037 (8.3%) of the 12 470 included ED visits. In 64 opioid users, an ADR was identified as a contributing cause of the ED visit, representing 6.2% of opioid users, and 0.5% of the total ED visits. Moreover, we identified an overdose in 16 opioid users, misuse or abuse in 19 opioid users, and compatible withdrawal symptoms in 7 opioid users. After pooling all these events, we conclude that the ED visits could be related to opioid use in 10.2% of opioid users. Finally, in 201 opioid users, insufficient pain relief (pain not responding to the current pharmacological treatment) was identified as a contributing cause of ED visits. In these cases, other factors than simply pharmacological nonresponse may have been involved. In the context of an ever-increasing opioid use to better control chronic pain situations, these results should reinforce emergency network epidemiological surveillance studies at a national level.

Keywords: adverse drug reaction; emergency division; opioids; pain.

Publication types

  • Review

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Drug Overdose* / diagnosis
  • Drug Overdose* / epidemiology
  • Drug Overdose* / therapy
  • Drug-Related Side Effects and Adverse Reactions* / drug therapy
  • Drug-Related Side Effects and Adverse Reactions* / epidemiology
  • Drug-Related Side Effects and Adverse Reactions* / etiology
  • Emergency Service, Hospital
  • Humans
  • Opioid-Related Disorders* / diagnosis
  • Pain / drug therapy
  • Tertiary Care Centers

Substances

  • Analgesics, Opioid