Retrospective Evaluation of Opioid Analgesics Use in Emergency Department: A One-Year Analysis
Methods: This is a single-centre, retrospective, and cross-sectional study conducted in the ED of Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. We retrospectively analysed the electronic medical records of all patients over 18 years of age who were received opioid analgesics in the ED for one year. Data included demographics data (gender, age), diagnosis, type of opioid drug used, hospitalisation and mortality. The study focused on the frequency of opioid use and type of opioid in ED.
Results: The study sample included 1392 patients with a mean age of 46.6 years. Of the patients who received opioid analgesics, 45.47% (n=633) were female and 54.53% (n=759) were male. The most common complaint was abdominal pain and 515 patients (37%) received opioids for this reason. The second most common diagnosis was myalgia with 123 patients (8.8%) and the third most common diagnosis was soft tissue injury with 107 patients (7.7%). The most commonly used opioid was fentanyl (n=746, 53.6%). This was followed by tramadol (n=611, 43.9%) and morphine (n=35, 2.5%).
Conclusions: Our study found that fentanyl was the most commonly used opioid in the ED, tramadol was preferred for non-traumatic patients such as myalgia, and morphine was rarely used. These results are in line with other data from our country and it has been observed that there is no excessive use of opioids.
1. Cordell WH, Keene KK, Giles BK, Jones JB, Jones JH, Brizendine EJ. The high prevalence of pain in emergency medical care. Am J Emerg Med. 2002;20(3):165-169. doi: 10.1053/ajem.2002.32643.
2. Jerant A, Agnoli A, Franks P. Satisfaction with Health Care Among Prescription Opioid Recipients. J Am Board Fam Med. 2020;33(1):34-41. doi:10.3122/jabfm.2020.01.190090.
3. Bertrand S, Meynet G, Taffé P, et al. Opiophobia in Emergency Department Healthcare Providers: A Survey in Western Switzerland. J Clin Med. 2021;10(7):1353. doi:10.3390/jcm10071353.
4. Baldemir R, Akçaboy EY, Noyan Ö, Akçaboy ZN, Baydar M, Çelik Ş. Doktorların opioid kullanımı ve opiofobiye yaklaşımlarının değerlendirilmesi: Bir eğitim ve araştırma hastanesinden anket sonuçları [An assessment of physicians attitudes toward opioid usage and opiophobia: Results of a survey from a training and research hospital]. Agri. 2019;31(1):23-31. doi: 10.5505/agri.2018.03411. [Article in Turkish]
5. Drug overdose death rates. Bethesda (MD): National Institute on Drug Abuse; 2023. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates (accessed 2023 Nov. 23).
6. Chen Q, Larochelle MR, Weaver DT, et al. Prevention of prescription opioid misuse and projected overdose deaths in the United States. JAMA Netw Open 2019;2:e187621. doi:10.1001/jamanetworkopen.2018.7621.
7. Daoust R, Paquet J, Émond M, et al; Quantity of Opioids for Acute Pain and Limit Unused Medication (OPUM) group on behalf of the Network of Canadian Emergency Researchers. Opioid prescribing requirements to minimize unused medications after an emergency department visit for acute pain: a prospective cohort study. CMAJ. 2024;196(25):E866-E874. doi: 10.1503/cmaj.231640.
8. Butler MM, Ancona RM, Beauchamp GA, et al. Emergency Department Prescription Opioids as an Initial Exposure Preceding Addiction. Ann Emerg Med. 2016;68(2):202-208. doi: 10.1016/j.annemergmed.2015.11.033.
9. Gleber R, Vilke GM, Castillo EM, Brennan J, Oyama L, Coyne CJ. Trends in emergency physician opioid prescribing practices during the United States opioid crisis. Am J Emerg Med. 2020;38(4):735-740. doi: 10.1016/j.ajem.2019.06.011.
10. Chang HY, Daubresse M, Kruszewski SP, Alexander GC. Prevalence and treatment of pain in EDs in the United States, 2000 to 2010. Am J Emerg Med. 2014;32(5):421-431. doi: 10.1016/j.ajem.2014.01.015.
11. Sevcik B, Lobay K, Luu H, et al. Analgesic Use Among Adults with a Trauma-Related Emergency Department Visit: A Retrospective Cohort Study from Alberta, Canada. Pain Ther. 2023;12(4):1039-1053. doi: 10.1007/s40122-023-00521-1
12. Cabıoğlu KS. Acil Tıp Kliniğine Ağrı Şikayeti İle Başvurup Opioid Analjezik İlaç Kullanılan Hastaların Geriye Dönük İncelenmesi [Retrospective Analysis of Patients Presenting to the Emergency Medicine Clinic with Pain Complaints and Using Opioid Analgesic Drugs]. Thesis. Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, 2017. [Article in Turkish]
13. Comer SD, Cahill CM. Fentanyl: Receptor pharmacology, abuse potential, and implications for treatment. Neurosci Biobehav Rev. 2019;106:49-57. doi: 10.1016/j.neubiorev.2018.12.005.
14. Bird HE, Huhn AS, Dunn KE. Fentanyl absorption, distribution, metabolism, and excretion: narrative review and clinical significance related to illicitly manufactured fentanyl. J Addict Med. 2023;17(5):503-508. doi:10.1097/ADM.0000000000001185.
15. Wenderoth BR, Kaneda ET, Amini A, Amini R, Patanwala AE. Morphine versus fentanyl for pain due to traumatic injury in the emergency department. J Trauma Nurs. 2013;20(1):10-5. doi:10.1097/JTN.0b013e31828660b5.
16. Subedi M, Bajaj S, Kumar MS, Yc M. An overview of tramadol and its usage in pain management and future perspective. Biomed Pharmacother. 2019;111:443-451. doi: 10.1016/j.biopha.2018.12.085.
17. Wu RR, Adjei-Poku MN, Kelz RR, et al. Trends in visits, imaging, and diagnosis for emergency department abdominal pain presentations in the United States, 2007-2019. Acad Emerg Med. 2025;32(1):20-31. doi:10.1111/acem.15017.
18. Falch C, Vicente D, Häberle H, et al. Treatment of acute abdominal pain in the emergency room: a systematic review of the literature. Eur J Pain. 2014;18(7):902-13. doi:10.1002/j.1532-2149.2014.00456.x.
19. Bartfield JM, Flint RD, McErlean M, Broderick J. Nebulized fentanyl for relief of abdominal pain. Acad Emerg Med. 2003;10(3):215-218. doi:10.1111/j.1553-2712.2003.tb01993.x.
20. Oguzturk H, Ozgur D, Turtay MG, et al. Tramadol or paracetamol do not effect the diagnostic accuracy of acute abdominal pain with significant pain relief - a prospective, randomized, placebo controlled double blind study. Eur Rev Med Pharmacol Sci. 2012;16(14):1983-1988.
21. Friedman BW, Irizarry E, Feliciano C, et al. A randomized controlled trial of oxycodone/acetaminophen versus acetaminophen alone for emergency department patients with musculoskeletal pain refractory to ibuprofen. Acad Emerg Med. 2021;28(8):859-865. doi:10.1111/acem.14231.
22. Lvovschi VE, Carrouel F, Hermann K, Lapostolle F, Joly LM, Tavolacci MP. Severe pain management in the emergency department: patient pathway as a new factor associated with IV morphine prescription. Front Public Health. 2024;12:1352833. doi: 10.3389/fpubh.2024.1352833.
23. Fabbri A, Voza A, Riccardi A, Serra S, Iaco F; Study and Research Center of the Italian Society of Emergency Medicine (SIMEU). The Pain Management of Trauma Patients in the Emergency Department. J Clin Med. 2023;12(9):3289. doi: 10.3390/jcm12093289.
24. Türkiye Cumhuriyeti İçişleri Bakanlığı Emniyet Genel Müdürlüğü Narkotik Suçlarla Mücadele Başkanlığı: Türkiye Uyuşturucu Raporu Eğilimler ve Gelişmeler [Republic of Türkiye Ministry of Internal Affairs General Directorate of Security Department of Combating Narcotic Crimes: Türkiye Drug Report Trends and Developments]. Ankara, 2024. [Article in Turkish]

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- Article Type Research Article
- Submitted February 21, 2026
- Published May 1, 2026
- Issue 2026: Online First
- Section Research Article