More ERs Treating Headaches With Narcotics, Study Finds
WEDNESDAY, April 2, 2014 -- There's been a big increase in prescriptions for powerful narcotic painkillers given to headache patients at hospital emergency departments, a new U.S. study finds.
This increase has occurred even though guidelines from a number of medical groups, including the American Academy of Neurology and the American College of Emergency Physicians, say these pain drugs should not be used as a first-line treatment for headache.
The study authors pointed out that this trend in emergency department prescribing practices has occurred at the same time that rates of abuse, overdose and deaths due to narcotics are on the rise in the United States.
The researchers analyzed national data from 2001 to 2010 and found a 65 percent increase in emergency department use of narcotic prescriptions for headaches during that period. The largest rise (450 percent) was in the use of hydromorphone, and there was also a significant increase in the use of oxycodone.
Over that same time period, the investigators found no increase in emergency department prescriptions for non-narcotic alternatives, such as acetaminophen (Tylenol), nonsteroidal anti-inflammatory drugs (NSAIDs), triptans (prescribed for migraines) and anti-emetic medications (used to treat nausea).
The study was presented at the American College of Medical Toxicology (ACMT) annual meeting, which concluded this week in Phoenix.
"These findings are particularly concerning given the magnitude of increase in [narcotic painkiller] prescribing compared to the other non-addictive medications, whose use remained the same or declined," lead investigator Dr. Maryann Mazer-Amirshahi, of George Washington University, said in an ACMT news release.
She added that there is concern "that providers are prescribing these medications, despite guidelines recommending against their routine use."
Study co-author Dr. Jeanmarie Perrone, of the University of Pennsylvania, noted that several factors may explain the increase in emergency department doctors' use of narcotic painkillers to treat patients with headaches, "including an increased focus on pain management, patient satisfaction, and regulatory requirements."
Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.
The U.S. National Institute of Neurological Disorders and Stroke has more about headache.
Posted: April 2014
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