Background and Aims Opioids are effective medications that have been used extensively for in-hospital management of acute pain. Worldwide including in Ireland, number of opioid prescriptions is increasing, although many reports encourage controlled usage and warned against the potential health, economic and social hazards involved in opioid usage. To address this problem and to increase knowledge and safety regarding opioid usage, The HSE has issued guidelines for opioid prescribing for the in-hospital management of acute pain. Aim: -To improve compliance with the relevant HSE prescribing guidelines. – Ensure that opioids were prescribed appropriately as per national guidelines. – Check opioid usage is part of multimodal analgesia as per WHO analgesia ladder.

Methods - A retrospective medical record review for opioid prescriptions for acute pain was conducted 3 times over the past year. anonymous data was collected. – survey for Junior Doctors to understand opioid prescription behavior. – teaching conducted at departmental and hospital levels to increase awareness.

Results 24% of the sample received SR opioid preparation. Regarding Immediate release opioids. Only 12% had a documented stop/review date. In terms of multimodal analgesia, a good portion of the sample received regular paracetamol (68%) however NSAIDs were generally underused, and only prescribed for 38% of patients.

Conclusions In our study, we observed a High rates of SR opioid preparation use in opioid naive patients to treat acute pain. Also, IR opioid recommended duration was not considered in most of the cases. Additionally. Multimodal analgesia usage to reduce opioid consumption could be improved.