Consumption of opioids in a hospital setting--what can we learn from a 10 year follow-up?

BACKGROUND: The World Health Organization considers a country's morphine consumption to be an important indicator of progress in pain relief. Despite the strong consensus favoring the use of opioids in many types of pain, limited data are available for gauging the trends in opioid usage in specific medical institutions, such as hospitals. OBJECTIVES: To assess the possibility that monitoring opioid consumption can shed light on directions and trends in the treatment of pain in a hospital setting. METHODS: Data on opioid consumption, number of inpatient days and number of operations performed each year during the period 1990-1999 were obtained from records kept in the hospital's pharmacy and archives. RESULTS: During that decade the overall opioid consumption in the hospital increased from the equivalent of 3.7 mg of oral morphine per inpatient day to 7.3 mg, and from 56 mg per surgical procedure to 100 mg. In 1990, injected opioids accounted for 93% of the overall consumption, whereas in 1999 they accounted for only 44%. Yet, the proportion of injected meperidine to injected morphine increased only from 43% to 51%. CONCLUSIONS: These results suggest that the ongoing monitoring of opioid consumption can highlight trends and directions and possibly emphasize strengths and weaknesses in the treatment of pain in hospitals.