Background: Hospital inpatients frequently require opioid analgesics for pain management, with more than half of US patients in acute-care facilities receiving opioids during their stay. With the rise of opioid drug therapy, the need to identify inpatient prescription patterns has become urgent, given that mortality rates attributed to prescription opioids have more than tripled since [...]

Background: Clinician prescribing practices are a contributing factor to and potential mitigator of the opioid epidemic in the United States. Several studies have identified the hospital setting as an important entry point into chronic opioid use. The Society for Hospital Medicine (SHM) and the Centers for Disease Control and Prevention (CDC) have made recommendations for [...]

Background: Development of opiate use disorder and opiate overdose has been associated with prolonged opiate-days prescribed. Conventionally, opiate-days supplied has been calculated based on the discharge prescription signature (e.g., how a patient is supposed to take the medication) and the number of pills dispensed. It is not clear whether the number of days supplied reflects [...]

Background: In March of 2016, the CDC released guidelines recommending shorter duration of opioid prescriptions. While these guidelines have the potential to influence hospitalist practice, it is not clear whether discharge prescribing patterns have changed for hospitalized patients. We perform an interrupted time series analysis to examine changes in discharge opioid prescribing from an inpatient [...]

Background: Subcutaneous (SC) methylnaltrexone (MNTX) is approved for opioid-induced constipation (OIC) in adults with chronic noncancer pain and OIC in adults with advanced illness or with active cancer who require opioid dosage escalation for palliative care. This post hoc analysis evaluated data pooled from 3 randomized studies of patients with advanced illness and OIC. Methods: [...]