Nearly 80% of ED patients treated with opioids report side effects

  • Am J Emerg Med

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Nearly 80% of ED patients who received short-term acute pain opioid treatment reported side effects similar to those experienced by patients who use opioids long-term to manage chronic pain, including constipation, nausea/vomiting, dizziness, and weakness.
  • Constipation was higher in older patients and those receiving higher-dose opioids, and nausea/vomiting and dizziness were more common in women and in patients who received oxycodone.

Why this matters

  • The majority of studies on side effects of opioid use have focused on people with chronic noncancer pain, with little data available on patients taking short-term opioids for acute pain.

Study design

  • Study of 386 patients with acute pain.
  • Funding: Hospital of the Sacred Heart of Montreal.

Key results

  • At 2 weeks, 80% of opioid users reported side effects.
  • Opioid use was associated with significantly higher risk for:
    • Constipation (aOR, 7.5; 95% CI, 3.1-17.9);
    • nausea/vomiting (aOR, 4.1; 95% CI, 1.8-9.5);
    • dizziness (aOR, 5.4; 95% CI, 2.2-13.2); and
    • weakness (aOR, 4.2; 95% CI, 1.6-11.0).
  • Patients aged ≥65 years (aOR, 1.9; 95% CI, 1.1-3.1) and with higher dose (>20 mg morphine equivalent vs 0: aOR, 13.3; 95% CI, 5.0-35.1) had higher risk for constipation.
  • Risk for nausea/vomiting and dizziness was significantly higher in women and patients who received oxycodone.

Limitations

  • Single-center study.

Coauthored with Antara Ghosh, PhD