Current or past substance abuse, mental health diagnosis, younger age, and male sex increased risk of subsequent opiate misuse after an initial opiate prescription.

Showing compassion to patients in the ED with a life threatening emergency reduced the odds of PTSD at one month.

Gabapentinoids were associated with increased risk of suicidal behavior, overdose, injuries, and car crashes.

Use of tramadol post-op was associated with an increased risk of prolonged use compared with other short acting opiates.

In heroin users specifically, 5% needed either repeat naloxone or oxygen > 2 hours after initial naloxone reversal. Observation for 3 hours may be safer, especially for those with polysubstance abuse.

Pretreatment with either midazolam or haloperidol prior to ketamine sedation markedly reduced the risk of recovery agitation but delayed recovery time by about 20-30 minutes.

The HOUR clinical decision rule can help determine which patients with opioid overdose who have received prehospital naloxone are safe for discharge after one hour of observation. But clinician judgment was just as good, which begs the question of why we need a decision rule.