Chronic opioid use and misuse after initial prescription at Dutch emergency departments

The prescription of opioids has increased significantly in recent years, raising concerns regarding opioid-related misuse, dependence, and associated adverse outcomes. Although emergency departments (EDs) frequently prescribe opioids for acute pain management, the extent to which these prescriptions contribute to persistent opioid use and opioid misuse remains unclear. Previous studies suggest that opioid prescriptions at the ED discharge may lead to prolonged opioid use, potentially resulting in opioid misuse or opioid use disorder (OUD). However, most of these studies originate from healthcare systems that differ significantly from the Dutch context. This study aims to assess the risk of chronic opioid use and misuse following an initial opioid prescription at ED discharge in the Netherlands.

The primary objective of this multicenter, observational study is to determine the incidence of chronic opioid use 30 days and 3 months after an initial opioid prescription at ED discharge. Secondary objectives include assessing the incidence of opioid misuse within this population and identifying patient-related, opioid prescription-related, and hospital-related predictors associated with prolonged opioid use and misuse.

This is a prospective, multicenter, observational study conducted in five hospitals in the Netherlands. Adult opioid-naïve patients discharged from the ED with a new opioid prescription will be invited to participate. Data collection will be conducted via digital questionnaires at three time points: within 1-7 days, at 30 days, and at 3 months post-discharge. 

This study does not involve the testing of a new drug or intervention. Instead, it focuses on the observational assessment of real-world opioid prescribing practices and subsequent opioid use patterns among ED patients. There are no experimental treatments or additional medical procedures involved.

The burden on participants is minimal, as the study only requires completion of three digital questionnaires at predefined time points, each taking approximately 15-20 minutes. There are no additional medical procedures or interventions. Participation is voluntary, and patients can withdraw at any time without consequences. Given the observational nature of the study, there are no direct medical risks associated with participation. The findings of this study may contribute to improved opioid prescribing practices and patient counseling regarding the risks of prolonged opioid use and misuse.