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Emergency department patients’ perceptions of the efficacy and safety of opioid analgesics

Maryann Mazer-Amirshahi, PharmD, MD, MPH, PhD, Christie Sun, MD, Lydia Koroshetz, BS, Rui W. Soares Jr, BS, Anagha Kumar, MS, MA, MBA, Diane P. Calello, MD, Jeanmarie Perrone, MD, Lewis S. Nelson, MD


Introduction: Emergency department (ED) providers are on the forefront of the prescription drug crisis and understanding patient’s perceptions of opioids may allow physicians to better address misconceptions. The aim was to determine the perceptions of ED patients regarding the efficacy and safety of opioid analgesics.

Methods: Cross-sectional study of a convenience sample of adults at a single urban academic ED. Patients completed a tablet-based survey regarding the efficacy and safety of opioid analgesics.

Results: Of the 715 subjects, the sample was predominantly black (80.4 percent), female (59.2 percent), and aged 18-59 years (76.8 percent). The majority (70.1 percent) of respondents reported pain as the reason for visit. Seventy-two percent had previously taken an opioid primarily for acute pain, found them effective for pain (88.2 percent), and would be willing to do so again (62.7 percent). Adverse effects made patients less likely to use them again (OR 0.703, [0.659-0.751]). Gender and age did not affect perceptions of efficacy and safety, but certain racial groups did (OR 1.08, [1.02 to 1.14], p < 0.05). Knowing someone who used opioids in a nonmedical manner did not impact willingness to use opioids. Many (54 percent) believed opioids to be as safe as nonopioid alternatives. The majority (78 percent) considered prescription opioid abuse a public health problem, however underestimated the number of annual opioid-related deaths.

Conclusion: The majority of ED patients had used opioids and considered the prescription drug crisis a public health problem. Through personal use or media coverage, the majority of participants considered opioids safe, even compared to nonopioid alternatives. Better understanding these viewpoints may improve patient–physician communication about analgesic treatment.


opioid, emergency, department, efficacy, safety

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