Photo Credit: Ivan-balvan

The following is a summary of “A Prospective Cohort Study to Determine Which Opioid-Naïve Emergency Department Patients Are at Risk of Persistent Opioid Use,” published in the April 2025 issue of Annals of Emergency Medicine by Abril et al. 

Researchers conducted a retrospective study to analyze whether opioid-induced euphoria and persistent pain 2 weeks after an emergency department (ED) visit were associated with continued prescribed opioid use among individuals who were opioid-naïve.  

They enrolled individuals during an ED visit and followed up via telephone at 48 hours, 2 weeks, and 6 months. The state prescription monitoring database was reviewed at 6 months. Persistent opioid use was defined as receiving at least 1 opioid prescription per month after ED discharge. At 48 hours, participants rated opioid-induced euphoria, joy, or happiness and the desire to use the medication again on a 0 to 10 scale. Pain levels were recorded using a 4-item ordinal scale: severe, moderate, mild, or none. (Persistent opioid use was defined as ≥1 opioid prescription/month after ED discharge.)  

The results showed that 699 individuals were eligible and enrolled, with 17 out of 699 (2%) developing new-onset persistent opioid use. The median rating for euphoria, joy, or happiness was 0 (interquartile range [IQR]: 0, 0), while the median desire to use the medication again was 6 (IQR: 0, 10). At 2 weeks, 296 out of 656 (45%) reported moderate or severe pain in the affected area. Neither opioid-induced euphoria, joy, or happiness (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.61 to 1.15) nor the desire to use the medication again (OR 1.06, 95% CI 0.92 to 1.21) showed an association with persistent opioid use. However, moderate or severe pain was associated with persistent opioid use (OR 5.15, 95% CI 1.43 to 18.50).  

Investigators concluded that the persistence of pain 2 weeks later without opioid-induced euphoria was associated with progression to persistent prescribed opioid use. 

Source: annemergmed.com/article/S0196-0644(25)00120-9/abstract