Quantity of opioids for acute pain and limit unused medication (OPUM)

Principal Investigator: Dr Raoul Daoust, Hôpital du Sacré-Coeur de Montréal

Local Investigator: Marcel Émond, MD, MSc, CHU de Québec- Université Laval

Co-Investigators: Chauny, JM; Choinière, M; Gosselin, S; Lang, E; Lavigne, G; Lee, J; Rouleau, D; Williamson, D;

Collaborators: Castonguay, V; Cournoyer, A; Lessard, J; Morris, Judy; Néron, A; Rainville, LF; Rochon, A;

Local research coordinator: Sandrine Hegg

Granting agency: Institut de Recherche en Santé du Canada (IRSC)

Pain-related conditions account for almost two-thirds of emergency department (ED) visits. Many of these patients (74%) are discharged from the hospital still suffering from moderate to severe pain. Few studies have assessed acute pain management after ED, and substantial numbers of patients continue to experience pain even seven days post-discharge. Accordingly, after an ED visit for a pain-related issue, 70 to 95% of patients receive a pain medication prescription, which they fill at a pharmacy up to 90% of the time. Management of severe acute pain frequently requires opioids (morphine and morphine-like substances, e.g., oxycodone, hydromorphone) to provide adequate relief. Consequently, opioids are often a significant part of the management of moderate to severe acute pain after an ED visit.

The ultimate goal of this research program is to decrease opioid misuse by lowering the amount of unused medications by patients with acute pain at ED discharge.

The primary objective of this project is to determine the quantity of opioids consumed during the acute pain phase (2 weeks) by ED-discharged patients treated for an acute pain condition. This will allow us to define the quantity of opioids needed to manage acute pain while limiting the quantity of unused pills available for potential misuse.