Cutting opioid dosage, changing delivery method could improve pain relief, study finds

After decreasing doses of opioid painkillers administered to hospital patients and delivering the medication with a shot or a pill as opposed to an IV, researchers found they could decrease patients' exposure to opioids while improving pain relief, according to a pilot study published in JAMA Internal Medicine.

For hospitalized patients, administering prescription opioid through an IV holds a greater risk of side effects since IV opioids quickly go through the central nervous system. Even one IV dose can cause changes in the brain linked to addiction, the researchers said.

To test an opioid-prescribing strategy that favors a shot under the skin or a pill instead of an IV, the researchers created an intervention involving several hundred hospital patients, and educated providers and nurses on the new standard.

During a three-month intervention period, the researchers measured patients' daily IV doses, non-IV doses and overall number of opioid doses per patient. They also analyzed how patients scored their pain during the first five days of being in the hospital.  

After comparing patient outcomes with a control group, the researchers found IV opioid dosing reduced by 84 percent in the intervention group, while patients' overall exposure to opioids also significantly declined. The study revealed patients in the intervention group reported pain scores that were similar or improved.

Although more research is necessary to validate the study findings, the results "have the potential to be practice-changing," lead author Adam Ackerman, MD, stated in a news release.

By altering how opioid painkillers are administered, hospitals could help fight patients' issues with substance abuse without altering pain control and potentially improving pain relief, the researcher said.  

"As physicians, we're obligated to provide help to the community. Part of that service is thinking analytically about how, when, and why we use opioids," said study co-author Robert Fogerty, MD. "The data show there are opportunities to improve the way we control pain and the way we impact the opioid crisis."

More articles on opioids: 
FDA investigation uncovers errors in opioid sales data from vendor IQVIA
Opioid crisis spurred increase in organ transplants, study finds
FDA greenlights first nonopioid drug for opioid withdrawal

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