New research led by the Mayo Clinic found commercially insured patients who were prescribed opioids from the emergency department were 44% less likely to exceed a three-day supply than those written elsewhere. Those patients were also 38% less likely to exceed a daily dose of 50 milligrams of morphine equivalent, which is almost seven pills of five-milligram oxycodone per day. An opioid prescribing guideline from the Centers for Disease Control and Prevention (CDC) issued in 2016 cautions against exceeding a three-day supply or 50 milligrams of morphine equivalent per day for acute pain.
There is a reason for that, because patients prescribed a higher dosage were three times more likely to progress to long-term use. ED patients with acute pain were 46% less likely to progress to long-term opioid use than those who received their prescription somewhere else. One in five commercially insured patients in a non-ED setting received a dose exceeding the CDC guideline, according to the study, which was published September 26 in the Annals of Emergency Medicine.