Safe practices for legitimate medical use of opioids: a study of trends in opioids prescription over a decade

Background: An unwavering availability of opioids is crucial for effective pain and palliative care and for managing opioid dependence. This study aims to study the pattern of morphine consumption and the use of safety protocols for prescribing opioids in a tertiary cancer hospital in India. Patients and methods: The medical and pharmacy records were studied retrospectively to investigate the pattern of oral Morphine consumption and distribution from 2008 to 2020. Results: The number of new cancer patients visiting the hospital, the number of re-visits of these patients, and inpatient admissions to palliative care services increased unswervingly from 2008 to 2019 with a sharp fall in 2020 owing to the COVID pandemic. Annual oral morphine consumption showed a steady increase from 4.89 kg in 2008 to 11.53 kg in 2019 with a fall to 5.68 kg in 2020. However, the trend for oral morphine dispensed per patient per visit showed a mild increase from 1.1 grams in 2008 to 2.06 grams in 2012, followed by a gradual decline to 0.89 grams in 2020. Opioid diversion incidence was found to be zero. Conclusions: Comprehensive interventions alongside safety protocols for prescriptions of opioids and effective integration of palliative care can help prevent opioid use disorders.