Background: The use and abuse of prescription opioid analgesics has never before received such global attention as it has in recent times. The extent of the problem in the USA. has been recognised, with six states recently declaring opioid abuse a state-wide emergency. In light of the alarming situation in the USA, we undertook an investigation of the scale of this problem in Ireland, and chose to examine opioid prescribing habits among surgeons in University Hospital Galway, specifically in relation to the final discharge prescriptions given to patients.
Methods: We retrieved consecutive samples of 40 surgical patient electronic discharge summaries, with representation from a variety of surgical departments, where opioids were prescribed on discharge. We then collected further data on patient demographics, diagnosis, primary procedure, length of stay and the presence or absence of other, non-opioid analgesics that were also prescribed. We then compared the agents prescribed with UHG guidelines on analgesia prescribing to assess whether prescription of opioids was warranted, and further, whether they were prescribed for an appropriate duration.
Results: In over 50% of cases sampled, opioids were either prescribed inappropriately, for an inappropriate duration, or were prescribed alongside additional analgesic agents, the appropriateness of which was unclear.
Conclusions: These results, obtained from the electronic discharge prescriptions of 40 surgical patients discharged over the last 5 months, are concerning and may indicate that opioid abuse is very much an unrecognised issue in the Irish population. Further investigation is needed to more accurately assess the true extent of this issue and the factors that influence it.
