Pattern of Prescription Opioid Use and Misuse among War-Injured Adults Receiving Treatments in Mekelle Trauma Centers, Northern Ethiopia

Abstract Opioid analgesics are commonly used for managing moderate to severe pain. While opioids can be effective for pain management, prolonged and inappropriate prescribing can pose risks such as abuse, and overdose. This study aimed to investigate the patterns of opioid use and misuse among war-injured adults in Mekelle trauma centers.A cross-sectional study design was used. The study participants were adults with war related traumatic injuries. Data was collected through a review of the medical records, patients self-report and from health care providers. Opioid misuse behavior was assessed using the Current Opioid Misuse Measure tool combined with clinical judgment. Statistical analysis was conducted using binary logistic regression. Results were presented as odds ratios with 95% confidence intervals. A p value of less than 0.05 was considered statistically significant.The study included a total of 310 adults with war-related traumatic injuries, predominantly male. About half of the participants were young adults aged between 18–24 years, with major traumatic injuries (Injury Severity Score above 15) and using opioids chronically. Tramadol was the most commonly prescribed opioid, accounting for 77.4% of all opioid prescriptions. Only 25.2% of participants were on multimodal analgesia. The intravenous route was the most commonly used route of opioid administration regardless of the injury severity and duration of analgesic use. The mean opioid dose used expressed as Morphine Milligram Equivalent (MME) per day (SD), was 45.04 (± 37.04). The mean duration of opioid treatment (SD) was 231.45 (± 257.17) days. Opioid misuse was identified in about 48% of the participants. Comorbid substance use (AOR = 62.03, p = 0.00), intravenous opioid administration (AOR = 8.09, p = 0.00), and not using multimodal analgesia (AOR = 0.016, p = 0.00) were independent predictors of opioid misuse.This study highlights significant challenges in opioid use, including the reliance on tramadol as the primary analgesic, and high rates of opioid misuse among traumatic injured adults potentially hindering their recovery. Training and educational programs targeting both healthcare providers and patients should emphasize the risks of long-term opioid use, safe practices, and alternative pain management options.