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Following hospitalization for orthopedic trauma, some patients continue to use opioids following fracture healing. This retrospective cohort study of 50 patients with high-energy fractures was conducted to determine if toxicology screening tests upon admission can predict subsequent opioid use. Data were collected from clinical records and a statewide electronic database of prescription records. Six months following hospital discharge, those with positive toxicology used more opioids (730 mg vs. 364 mg; P = .04) expressed as morphine equivalents than those with negative toxicology and were more likely to continue using opiates at the end of the 3rd, 4th, 5th, and 6th month after discharge. Patients hospitalized for high-energy fractures with positive admission toxicology are at risk for prolonged opiate use during the initial six months following discharge. [ABSTRACT FROM AUTHOR]

Patients who are physically dependent on prescription drugs often create clinical management problems during hospitalization. Identifying those patients who have prescription drug problems can be difficult at the time of admission, but the information of the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system can be useful clinically. The purpose of this study was to examine the value of the KASPER system in the management of patients admitted to an acute care hospital. A convenience sample of 58 hospitalized patients was evaluated. The patients' clinical and demographic data were abstracted from the medical record. The KASPER data were used to confirm the patients' history of drug use. In this sample, the KASPER data supplied additional, clinically useful information that was not available from the clinical history or screening toxicology from 30 (51.7%) of these patients. We conclude that the KASPER system has the potential to assist physicians in the care of hospitalized patients who take controlled drugs that are obtained by physician prescription and filled in Kentucky pharmacies.