Emergency Department Admission Rate Increase for Opioid Analgesic Misuse/Abuse (2004-2011)
Between 2004 and 2011, emergency department admission rates for misuse or abuse of opioid analgesics in the United States increased by 245%. 1
Key Epidemiologic Data
The dramatic escalation in opioid-related ED visits during this period reflects a broader public health crisis:
Overall misuse increased 245% from 2004 to 2011, representing a sharp acceleration compared to the 1,372% increase seen in the earlier period from 1996 to 2004 1
This increase occurred despite medical use of opioids increasing by only 100% during the same timeframe, demonstrating that misuse was growing at more than twice the rate of legitimate medical use 1
Specific Opioid Breakdown (2004-2011)
The increases varied substantially by specific opioid analgesic 1:
- Hydromorphone: 438% increase (highest)
- Buprenorphine: 384% increase (data from 2006-2011 only)
- Oxycodone: 263% increase
- Morphine: 146% increase
- Hydrocodone: 107% increase
- Fentanyl: 104% increase
- Methadone: 82% increase
- Codeine: 39% increase (lowest)
Clinical Context and Mortality Impact
This period represented a critical inflection point in the opioid epidemic. The guideline evidence confirms that opioid analgesic deaths exceeded those from cocaine and heroin combined during this timeframe, with reported overdose deaths increasing from 4,030 in 1999 to 14,800 in 2008 2
Important caveat: The 245% figure represents ED visits for misuse/abuse specifically, not all opioid-related ED encounters. The strong correlation between prescribing patterns and ED visits (correlation coefficients 0.73-0.87 for hydrocodone and oxycodone) demonstrates the direct relationship between increased medical availability and subsequent misuse 3