With Fewer Opioids Being Prescribed in the ED, Will Urgent Care See More Drug Seekers?

Recommendations to carefully consider which patients truly need opioid pain medications are having their intended effect in emergency rooms across the U.S. According to new data just released by the Centers for Disease Control and Prevention, a downward trend in patients receiving a prescription for opioids when they check out of the ED is ongoing. (In the period of 2010–2011, 21.5%  of patients left the ED with a prescription for opioids; in the 2016–2017 study period, that figure was down to 14.6%.) While that’s good news, and shows efforts to prescribe more responsibly are succeeding, the patients who do receive opioids often struggle with their unintended consequences. In 2017, 36% of opioid-related overdose deaths occurred through use of medication that was prescribed to the victim, not obtained or used through illicit means. The question remains, however, as to whether patients who try to obtain prescriptions for opiates for recreational use or to feed their addiction will try elsewhere—such as their local urgent care center. Be vigilant for drug seekers. JUCM has addressed the subject of evaluating pain in the urgent care center in the past. You can read Evaluation and Management of Pain: Acute Pain in our archive right now. And look for the April issue in the coming weeks, in which we’ll offer original research addressing the question of whether pain should be considered as the “fifth vital sign.”