Opioid utilization and opioid‐related adverse events in nonsurgical patients in US hospitals

Herzig, Shoshana J.; Rothberg, Michael B.; Cheung, Michael; Ngo, Long H.; Marcantonio, Edward R.

doi:10.1002/jhm.2102

Cited by 167Opioid Use Disorder TreatmentPain Management and Opioid UsePharmaceutical Practices and Patient Outcomes

Opioid utilization and opioid‐related adverse events in nonsurgical patients in US hospitals

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Herzig, Shoshana J., Rothberg, Michael B., Cheung, Michael, Ngo, Long H., Marcantonio, Edward R.·2014·Journal of Hospital Medicine

DOI 10.1002/jhm.2102PMC PMC3976956

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Abstract

BACKGROUND: Recent studies in the outpatient setting have demonstrated high rates of opioid prescribing and overdose‐related deaths. Prescribing practices in hospitalized patients are unexamined. OBJECTIVE: To investigate patterns and predictors of opioid utilization in nonsurgical admissions to US hospitals, variation in use, and the association between hospital‐level use and rates of severe opioid‐related adverse events. DESIGN, SETTING, AND PATIENTS: Adult nonsurgical admissions to 286 US hospitals. MEASUREMENTS: Opioid exposure and severe opioid‐related adverse events during hospitalization, defined using hospital charges and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes. RESULTS: Of 1.14 million admissions, opioids were used in 51%. The mean ± standard deviation daily dose received in oral morphine equivalents was 68 ± 185 mg; 23% of exposed received a total daily dose of ≥100 mg oral morphine equivalents. Opioid‐prescribing rates ranged from 5% in the lowest‐prescribing hospital to 72% in the highest‐prescribing hospital (mean, 51% ± 10%). After adjusting for patient characteristics, the adjusted opioid‐prescribing rates ranged from 33% to 64% (mean, 50% ± standard deviation 4%). Among exposed, 0.60% experienced severe opioid‐related adverse events. Hospitals with higher opioid‐prescribing rates had higher adjusted relative risk of a severe opioid‐related adverse event per patient exposed (relative risk: 1.23 [1.14‐1.33] for highest‐prescribing compared with lowest‐prescribing quartile). CONCLUSIONS: The majority of hospitalized nonsurgical patients were exposed to opioids, often at high doses. Hospitals that used opioids most frequently had increased adjusted risk of a severe opioid‐related adverse event per patient exposed. Interventions to standardize and enhance the safety of opioid prescribing in hospitalized patients should be investigated. Journal of Hospital Medicine 2014;9:73–81. © 2013 Society of Hospital Medicine

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More than half of patients in the U.S. are treated with opioids during hospitalization.
“For alleviation of pain, more than half of patients in the U.S. are treated with opioids during hospitalization, 6”
From Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting. (2017) · cites this paper as [6]
The Discussion reports that more than half of hospitalized non-surgical patients received opioids in a study of U.S. acute care facilities. The claim extends that finding to hospitalized patients generally; the Introduction identifies pain as a reason opioids may be used but does not establish that every opioid treatment counted was for pain relief. (LLM, conf=0.88)
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ORIGINAL RESEARCH Opioid Utilization and Opioid-Related Adverse Events in Nonsurgical Patients in US Hospitals
Herzig, S. J., Rothberg, M. B., Ngo, L. H., & Marcantonio, E. R. (2014)
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National Level Analysis of Opioids-Related Death and Hospital Adverse Drug Events, 2009-2014
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Authors: Herzig, S. J., Rothberg, M. B., Cheung, M., Ngo, L. H., & Marcantonio, E. R.
Affiliations: Beth Israel Deaconess Medical Center (US)
Cleveland Clinic (US)
ORCID: Herzig, Shoshana J.
Rothberg, Michael B.
Ngo, Long H.
Marcantonio, Edward R.
Venue: Journal of Hospital Medicine
Publisher: Wiley
Published: 2013-11-13
Volume: 9
Issue: 2
Pages: 73-81
ISSN: 1553-5592 (ISSN-L)
1553-5606
DOI: 10.1002/jhm.2102
PMC: PMC3976956
OpenAlex: W2128615039
Cited by: 167
References: 33
Citations by year: 2026: 4 · 2025: 10 · 2024: 10 · 2023: 3 · 2022: 16 · 2021: 33 · 2020: 17 · 2019: 28 · 2018: 16 · 2017: 10 · 2016: 6 · 2015: 8 · 2014: 5
FWCI: 6.48
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Hospital Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (P01AG031720, K24AG035075, K23AG042459, R03AG028189, R01AG030618)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords: opioid prescribing, opioid side effects, hospitalized patients, opioid overdose, morphine milligram equivalents, hospital-level variation, opioid safety
MeSH terms: Adolescent, Adult, Aged, Analgesics, Opioid, Drug Utilization, Female, Hospitalization, Hospitals, Humans, Male, Middle Aged, Retrospective Studies, United States, Cohort Studies, Young Adult

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Opioid utilization and opioid‐related adverse events in nonsurgical patients in US hospitals

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