A study by Dana Goldman and colleagues shows that a large number—nearly 15 percent—of Medicare patients receive their first prescription for opioids within a week of being discharged from the hospital and many of them—43 percent—were still taking opioids three months after discharge. Most of these patients were 65 and older. While opioid use during and shortly after an acute hospitalization is warranted in some clinical settings, given the potential of opioids for short-term adverse events and long-term physiologic tolerance, it is important to understand the frequency of opioid prescribing at hospital discharge, hospital variation, and patient and hospital factors associated with opioid prescribing. Health officials have encouraged reductions in opioid prescriptions, but as a foreseeable consequence, some abusers denied additional prescriptions have turned to heroin to maintain their addiction. The authors urged caution in implementing solutions without sufficient evidence of their effectiveness.
Citation: Jena, A. B., Goldman, D., & Karaca-Mandic, P. (2016). Hospital Prescribing of Opioids to Medicare Beneficiaries. JAMA Internal Medicine.