title: Descriptive study of prescriptions for opioids from a suburban academic emergency department before New York's I-STOP Act.
abstract: BACKGROUND
  Controlled prescription opioid use is perceived as a national problem attributed to all specialties. Our objective was to provide a descriptive analysis of prescriptions written for controlled opioids from a database of emergency department (ED) visits prior to the enactment of the I-STOP law, which requires New York prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing Schedule II, III, and IV controlled substances for prescriptions of greater than five days duration.
  
  
  METHODS
  We conducted a retrospective medical record review of patients 21 years of age and older, who presented to the ED between July 1, 2011 - June 30, 2012 and were given a prescription for a controlled opioid. Our primary purpose was to characterize each prescription as to the type of controlled substance, the quantity dispensed, and the duration of the prescription. We also looked at outliers, those patients who received prescriptions for longer than five days.
  
  
  RESULTS
  A total of 9,502 prescriptions were written for opioids out of a total 63,143 prescriptions for 69,500 adult patients. Twenty-six (0.27%) of the prescriptions for controlled opioids were written for greater than five days. Most prescriptions were for five days or less (99.7%, 95% CI [99.6 to 99.8%]).
  
  
  CONCLUSIONS
  The vast majority of opioid prescriptions in our ED prior to the I-STOP legislature were limited to a five-day or less supply. These new regulations were meant to reduce the ED's contribution to the rise of opioid related morbidity. This study suggests that the emergency physicians' usual prescribing practices were negligibly limited by the new restrictive regulations. The ED may not be primarily contributing to the increase in opioid-related overdoses and death. The effect of the I-STOP regulation on future prescribing patterns in the ED remains to be determined.
authors: Good Samaritan Hospital Medical Center, Department of Emergency Medicine, West Islip, New York.
authors: Lyncean
authors: L
authors: Ung
authors: Premier Care Physicians, Department of Emergency Medicine, Bellmore, New York.
authors: Ronald
authors: R
authors: Dvorkin
authors: Good Samaritan Hospital Medical Center, Department of Emergency Medicine, West Islip, New York.
authors: Steven
authors: S
authors: Sattler
authors: New York Colleges of Osteopathic Medicine Educational Consortium, New York, New York ; Touro College of Osteopathic Medicine, Middletown, New York.
authors: David
authors: D
authors: Yens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid