The relationship between narcotic administration and Emergency Department recidivism

Pain is the most common problem presented by patients admitted to the Emergency Department (ED) of general medical hospitals (Grant, 2006). Despite increased attention in the general medical field, little research has been dedicated to examining the specific challenges of pain in emergency medical care. This lack of research, coupled with the high prevalence of complaints of pain in EDs, is both a cause for concern as well as an opportunity for improvement (Cordell et al., 2002; Gallagher, 1998). As EDs continue to experience overwhelming crowding (Hauswald, 2004), efficient and effective pain management is an increasingly important component of emergency medical care (Wilsey et al., 2004). The present study was designed to investigate the impact of narcotic administration on ED recidivism. The null hypothesis of the proposed study was that there would be no statistically significant difference in ED recidivism for patients who are administered or prescribed a narcotic versus those who are not. A second investigative question explored the differential administration and prescription of narcotics by different physicians in one general medical hospital. A total of 86 Emergency Department patients' medical records were reviewed from the twelve-month period between June 1, 2006 and June 1, 2007. Results indicated that the number of visits for those who received narcotics was significantly higher than for those that did not receive narcotics. Likewise, this study also suggested that there is a difference between physicians in the rate of narcotic administration for patients presenting with pain in the Emergency Department of the same medical hospital. This study shows that an established protocol for treating patients with chronic pain who present in the ED may be useful in reducing ED recidivism and in changing the attitudes of emergency medical providers about pain assessment and management.