Usage Patterns of Narcotic Analgesics in Emergency Departments

Introduction: Aggressive pain management with opioids has contributed to an opioid abuse epidemic. Although there is a substantial body of research in Western literature, data pertaining to Türkiye remain limited. The aim of our study was to examine the usage patterns of narcotic analgesics in the emergency department (ED). Methods: This retrospective study analyzed patients assessed in the red zone between January 1, 2024, and December 31, 2024, who were prescribed narcotic analgesics or other potentially addictive drugs for any reason. Demographic information, patient complaints, reasons for drug administration, and specific drugs used were recorded. Results: During the study period, 16,062 patients were admitted to the red zone. The study examined 1,171 drug applications administered to 1,062 distinct patients. In 63% of the patients, the primary reason for drug administration was pain management. Tramadol was the most commonly used narcotic, administered 601 times. It was given to 296 patients for managing pain related to abdominal pathologies, as a first-line medication in 67.6% of these cases. Fentanyl was administered to 100 patients, for whom trauma was the leading indication. During the study period, 24 patients were admitted to the ED due to drug abuse. Naloxone was required for only 3 of these patients, while the remaining were managed with benzodiazepines. Conclusion: This study provides valuable insights into the current trends and challenges associated with narcotic analgesic use in emergency care. Continued efforts to refine protocols will be crucial in optimizing pain management, addressing the opioid epidemic, and implementing strategies to prevent it.