OPIOID delivery through non-intravenous (IV) methods to hospitalised patients can decrease exposure to these drugs as well as improve pain relief, according to researchers from Yale University, New Haven, Connecticut, USA. The team believe the findings could lead to changes in hospital practices and could also help reduce addiction and overdose deaths from opioids.
Side Effects of Intravenous Opioids
Typically, hospitalised patients are prescribed opioid drugs in three forms to relieve pain: an IV, orally, or with a shot in the skin. There is a greater risk of side effects with the IV method because IV opioids rapidly penetrate the central nervous system, and even just a single IV dose has been shown to cause brain changes associated with addiction.
A new standard of opioid prescribing that favours non-IV delivery was tested by the team in a study of a few hundred patients that also involved education for the doctors and nurses about the new standard. In the trial, which has completed its second and third Phases, the patients were placed into intervention and control groups. In addition to measuring daily IV doses, non-IV doses, and overall opioid doses per patient over the 3-month intervention period, pain scores over the first 5 days of hospitalisation were also analysed.
Reduced Exposure and Improved Pain Scores
The researchers found an 84% reduction of IV opioid dosing in the intervention group, and that there was also a substantial decrease in overall opioid exposure. Additionally, these patients had similar or improved pain scores.
“These data show that the non-IV use of opioids can reduce overall opioid use in adult inpatients with no change in pain control, and potentially an improvement,” commented co-author Dr Robert Fogerty, Yale University. “It’s an example of less is more.”
The study could lead to hospitals adapting their opioid prescription methods, although further research is needed to confirm the results. Additionally, the new standard could help reduce addiction and overdose deaths from the painkillers.
“The study represents an important piece of the puzzle in terms of how opioids can be used more safely and effectively in clinical practice,” said co-author Dr Patrick O’Connor, Yale University. “It also represents a critical strategy for reducing the potential risk of opioid-related complications, including overdose and death.”
James Coker, Reporter
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