Think Even Harder About Prescribing Opioids as the Day Wears On

Chances are you think long and hard before prescribing opioids, and consider how long a patient will really need that level of pain relief if you do decide they’re necessary, in these days of rampant addiction. An article published in the Journal of General Internal Medicine suggests that physicians should mull that over even more toward the end of their shift, as the likelihood of prescribing an opioid product is 60% higher in the last hour of a 4-hour period compared with the first hour. While those data were drawn from physicians evaluating patients for back pain specifically, they speak to a certain fatigue or desensitization process that can affect decision making. The researchers adjusted for factors including education, employment, smoking status, the provider’s experience, average pain score, and the overall length of each appointment. The authors also reported that their findings called to mind the results of a 2014 study that showed the likelihood of prescribing antibiotics inappropriately for acute respiratory infections rose as the day progressed.