ICU Management & Practice, Volume 19 - Issue 2, 2019


According to a new study, opioids prescribed in the intensive care unit (ICU) do not drive risks for continued use or prescriptions. The findings were presented at the American Thoracic Society (ATS) 2019 International Meeting in Dallas, TX.


Opiate abuse is a major healthcare issue. In the U.S., opioid-related deaths have increased more than three-fold from 2000 to 2016. The use of opioids in the ICU have to follow guidelines that are adjusted to a standard based on necessary opiate exposure only. This applies to parenteral opioids and oral opioids.


The study was conducted with 3102 opiate-naive patients admitted from 2016-2017. 45% of these patients received opioids in the ICU and were exposed according to their prescription. As a general profile, opioid-receiving patients were younger, with greater weight, height, APACHE scores, and greater lengths of stay in both the hospital and the ICU. The primary outcome of the study was opioid prescriptions within 1-year post-discharge.


Study investigators from the Cleveland Clinic and Duke University Medical Center shared the findings that patients who were prescribed opioids in the ICU did not report an increase in the risk of continued opioid prescription at 1 year after discharge. These findings thus support the guideline set by the Society of Critical Care Medicine regarding the management of pain, agitation, and delirium.


Healthcare providers should continue to address pain optimally and should manage patients in the ICU by using the comprehensive bundle to provide comfort as well as prevent delirium.



Chen A et al. (2019) Use of Opioids in the Medical Intensive Care Unit Is Not Associated with Outpatient Opiate Use. ATS International Conference. Available from!/5789/presentation/26085