Lyapustina Tatyana, Castillo Renan, Omaki Elise, Shields Wendy, McDonald Eileen, Rothman Richard, Gielen Andrea
University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
Pain Pract. 2017 Nov;17(8):1097-1104. doi: 10.1111/papr.12568. Epub 2017 Mar 20.
Prescription opioid pain reliever (OPR) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPRs, yet the relative contribution of emergency department (ED) OPR prescriptions to the overall opioid abuse epidemic remains unclear. This study critically reviews seven peer-reviewed studies that specifically identified the ED as a source of OPRs. Of the OPRs prescribed in the ED, approximately 10% are associated with indicators of inappropriate prescribing, and approximately 42% may ultimately be misused; of the OPRs that are diverted, approximately 10% originate from an ED prescription. Among patients who suffer an OPR-related death, approximately 1.8% of the OPR pills given to the decedents will have come from the ED. In addition to the need for more research, the existing literature suggests an urgent need for interventions in the ED to reduce OPR misuse and diversion.
处方类阿片类镇痛药（OPR）的滥用和转移是美国一个重要且日益严重的公共卫生问题，导致了大量的发病和死亡。急诊医生是OPR的主要开方者之一，但急诊室（ED）的OPR处方对整体阿片类药物滥用流行的相对贡献仍不明确。本研究批判性地回顾了七项经同行评审的研究，这些研究特别将急诊室确定为OPR的一个来源。在急诊室开出的OPR中，约10%与不适当处方的指标相关，约42%最终可能被滥用；在被转移的OPR中，约10%源自急诊室处方。在与OPR相关死亡的患者中，给予死者的OPR药丸约1.8%来自急诊室。除了需要更多研究外，现有文献表明迫切需要在急诊室采取干预措施，以减少OPR的滥用和转移。
