BACKGROUND

Increasing rates of opioid prescribing are a growing concern due to associations with dependency and misuse. Management of pain in trauma is important, but represents an under-investigated opioid initiation event. This study aimed to analyze opioid prescription patterns at discharge in trauma patients within a provincial setting in Aotearoa New Zealand.

METHODS

To address this aim, a cohort of 500 trauma patients aged 18-64 years, admitted to Tauranga or Whakatāne Hospital between 21 April 2017 and 31 December 2017, were retrospectively assessed. Data were sourced from the Midland Trauma Registry (MTR), which captures patients admitted to hospital within 7 days of injury. Opioid prescriptions at discharge and repeat prescriptions up to 12 months post-discharge were assessed, with doses standardized using Morphine Milligram Equivalents (MMEs).

RESULTS

Of the 473 opioid-naïve patients identified, 69.1% were prescribed opioids at discharge. A higher Injury Severity Score (ISS) was associated with increased opioid prescribing at discharge and a higher likelihood of repeated opioid prescriptions after discharge. Within 3 months, 36.1% of patients received repeat prescriptions, decreasing to 13.5% between 3 and 6 months and 7.3% between 6 and 12 months.

CONCLUSION

This is the first reported study assessing opioid prescribing after trauma in Aotearoa New Zealand and found that a higher ISS was associated with increased opioids prescribed at discharge and a greater risk of repeat prescriptions. These findings highlight the importance of education and prescribing protocols to balance pain management with the risk of long-term use.