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Opioid use at admittance increases need for intrahospital specialized pain service: Evidence from a registry-based study in four Norwegian university hospitals

Year: 2025

Type: article

Abstract: OBJECTIVES: Acute Pain Services (APS) have significantly evolved since their establishment in the 1990s, emphasizing multimodal analgesia, which is a pivotal component of enhanced recovery after surgery, to enhance postoperative recovery. Despite improvements, variability in pain trajectories among patients necessitated the development of transitional pain units to address individual needs and ensure safe opioid tapering. The Norwegian National Registry for Advanced Acute Pain Services (AAPS), known as SmerteReg, was established to further enhance understanding of pain treatment in these patients. In this study, we aimed to analyze opioid use patterns and characteristics of opioid users referred to AAPS compared to non-opioid users. METHODS: Data from SmerteReg (2016-2020) were analyzed, including patient demographics, diagnoses, pain treatment, and patient-reported outcome measures. Patient characteristics at admittance were compared between opioid users and non-opioid users. Multivariate logistic regression was used to explore factors associated with opioid use. RESULTS: Of 1,068 patient tracks, 64% were opioid users at admittance. Opioid users were older and more frequently female, reporting higher levels of anxiety, depression, catastrophizing, and sleep problems before admission. Sleep problems before admittance was reported three times more frequent by patients using opioids compared to patients not using an opioid at admittance. CONCLUSION: Pre-admittance opioid use was prevalent among patients referred to AAPS, emphasizing the need for tailored pain management strategies. Women, older patients, and those reporting sleep problems before admittance were more likely to use opioids. The finding that sleep problems before admittance were strongly associated with opioid use, suggests the importance of addressing sleep disturbances in pain management protocols. This study contributes to understanding opioid use patterns and factors influencing pain management in hospitalized patients.

Source: Scandinavian Journal of Pain

DOI: 10.1515/sjpain-2025-0008

Authors: Torbjørn Nordrik, Elisabeth Ørskov Rotevatn, Janne Mannseth, Audun Stubhaug, Lars Jørgen Rygh

Institutions: Haukeland University Hospital, University of Bergen, Oslo University Hospital, University of Oslo

Language: English

Topic: Opioid Use Disorder Treatment

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,260