ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2020
Association of Emergency Department Opioid Administration With Ongoing Opioid Use: A Retrospective Cohort Study of Patients With Back Pain.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Pooled it
- Opioid Analgesic Use After an Acute Pain Visit: Evidence from a Urolithiasis Patient Cohort.The western journal of emergency medicine · 2022Trial
- Association of acute opioid-induced euphoria and analgesia with subsequent opioid prescriptions in an emergency department-based prospective cohort study.Clinical and experimental emergency medicine · 2026Article
- Examining Statewide Opioid Prescribing Limits and Prescription Drug Monitoring Program Mandates: Provider Compliance and Patient Outcomes.AJPM focus · 2026Article
- Still Hurting: Low Back Pain Presentations in the Emergency Department: A Retrospective Observational Study With a Cross-Sectional Follow-Up Survey.Pain research & management · 2026Observational
- Article
- Implementation of an ultrasound-guided nerve block program in an academic emergency department.Frontiers in public health · 2025Article
- Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department.JAMA network open · 2024Observational
- Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study.The Journal of emergency medicine · 2024Observational
- Opioid Risk Tool, in-hospital opioid exposure, and opioid demand predict pain outcomes following traumatic injury.Journal of health psychology · 2024Article
- Contextualising opioid-related risk factors before an initial opioid prescription.BMJ quality & safety · 2023Article
- Associations Between Management Pathway and Opioid Prescriptions for Patients Entering the Emergency Department With Neck and Back Pain.Mayo Clinic proceedings. Innovations, quality & outcomes · 2023Article
- Concordance of opioid exposure in all-payer claims databases with prescription drug monitoring program database using Arkansas as a case example.Health services research · 2023Article
- Association between clusters of back and joint pain with opioid use in middle-aged community-based women: a prospective cohort study.BMC musculoskeletal disorders · 2021Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesOpioids are commonly administered in the emergency department (ED) and prescribed for the treatment of back pain. It is important to understand the unintended consequences of this approach to inform treatment decisions and the consideration of alternative treatments. Recent evidence has shown that ED opioid prescriptions are associated with future opioid use. The objective of this study was to measure the association of opioid administration in the ED to patients treated for back pain with future opioid use.
methodsThis is a retrospective study of opioid-naïve adults discharged from the ED with a diagnosis of back pain. Patients were stratified by opioid therapy (none, ED administration only, prescription only, or ED administration + prescription). Relative risks of ongoing opioid use (filling >90-day supply in 180 days following ED visit as documented in the prescription drug monitoring program) were calculated for each opioid-therapy group and compared to the no-opioid group.
resultsWe identified 24,487 opioid naïve back pain patients. The median age was 38 years, 55% were female, and 56% were non-Hispanic white. A total of 41% received no opioid, 10% were only administered an opioid in the ED, 18% only received a prescription, and 31% received an opioid in the ED + prescription. The adjusted relative risks of ongoing use compared to the no opioid group were as follows: ED only 1.9, prescription only 2.1, and ED + prescription 2.3. The increased risk persisted for other definitions of ongoing use and after adjustment for baseline pain scores.
conclusionsFor opioid-naïve patients with back pain, both administration of an opioid in the ED and opioid prescriptions are associated with a doubling of the risk of ongoing opioid use compared to patients not treated with opioids. This supports the consideration of minimizing exposure to opioids while treating back pain in the ED.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.