Opioid for in-hospital admitted patient analgesics; which demographics and psychiatric profiles need more pain drugs?

Introduction: The prevalence of substance use disorders is higher in patients receiving opioid analgesics, and pain management in these patients is more challenging. This study aimed to investigate the pattern of analgesic drug administration and evaluate the associated factors.
Method: The cross-sectional study was performed on 230 patients admitted to General Hospital ( internal medicine, surgery, and cancer wards).
Result: The most used analgesic drug was morphine (59.4%), and a mean dose of 27 mg, then pethidine and methadone. Most pain control methods were intravenous (68.1%) and PRN pattern (61.1%). Using analgesics in patients who do not have risk factors for drug abuse, or addiction, can be considered safe. In our subjects, 95.6% of analgesic users did not become addicted or had any misuse.
Discussion and Conclusion: For effective and low-risk treatment of these patients, there is a need for clinical skills, knowledge of opioid administration, assessment, and risk management of substance abuse and addiction. In patients with substance abuse, analgesics should be prescribed in a particular setting, under supervision, and with careful monitoring. Structured and planned administration of opioid agonists (such as methadone or buprenorphine) seems appropriate according to a structured schedule. These plans are recommended:
·         Increasing the awareness of clinicians about prescribing narcotic analgesics.
·         Prescribing narcotic analgesics with a regular pattern against PRN.
·         Evaluating patients for a history of substance abuse.
·         Closely monitoring them, and if necessary.
·         Counseling.
Identifying high-risk groups such as women, youth, and psychiatric patients are also recommended, and performing early interventions.