835: Opioid Administration During ICU and Post ICU Care and Discharge Opioid Prescribing Practices

The complications of opioid use during and post–intensive care admission: A narrative review

“…The incidence of chronic post-ICU opioid use ranges from 2.6% to 16.3% in patients who were opioid-naive prior to ICU admission. 1,34,70 –72,74 –79 Trials with a larger incidence of persistent opioid use used a definition of single prescriptions of opioids. Using a time-based prescription of 120 days of opioid supply within the first year after ICU hospitalisation, Wunsch et al.…”

“…Wampole et al. 78 found that 70% of chronic opioid users had one opioid prescription filled at three months post-discharge, with similar proportions at six and 12 months. Again, these results should be interpreted with caution as the outcomes are based on single prescriptions of opioids.…”

“…Several studies of varying ICU cohorts have analysed the incidence and potential causative factors associated with persistent opioid use after the ICU. 1,34,[69][70][71][72][73][74][75][76][77][78][79] Overall, the incidence of persistent opioid use after the ICU ranges from 2.6% to 70%. This observed variability is due to the inclusion of patients with preexisting opioid use, variable time to follow-up, differing definitions of chronic opioid therapy and the patient cohort being studied.…”

“…The incidence of chronic post-ICU opioid use ranges from 2.6% to 16.3% in patients who were opioid-naive prior to ICU admission. 1,34,[70][71][72][74][75][76][77][78][79] Trials with a larger incidence of persistent opioid use used a definition of single prescriptions of opioids. Using a timebased prescription of 120 days of opioid supply within the first year after ICU hospitalisation, Wunsch et al reported the incidence of chronic opioid therapy in ICU patients receiving mechanical ventilation to be 2.6%, 1 with prescriptions occurring more in surgical patients than medical patients (4.1% versus 1.6% at 12 months).…”

“…Dunn et al 70 also found a high incidence of opioid prescription, with 61% and 44% of traumatic brain-injured patients still receiving an opioid prescription at six and 12 months, respectively. Wampole et al 78 found that 70% of chronic opioid users had one opioid prescription filled at three months post-discharge, with similar proportions at six and 12 months. Again, these results should be interpreted with caution as the outcomes are based on single prescriptions of opioids.…”