Patterns of opioid and sedative use in adult ICUs: Insights from the ALERT-ICU study on iatrogenic withdrawal syndrome
Authors' conclusion
Over half of adult ICU patients are administered regularly dosed parenteral opioids-sedatives for ≥72 h, often at higher doses, potentially increasing the risk of IWS.
Study context
- Population
- Adults (≥18 y) in adult ICUs who received parenteral opioids or sedatives in the previous 24 h
- Participants
- 1,506 adults · 229 ICUs · 11 countries
- Outcome
- Proportion of patients receiving regularly dosed parenteral opioids or sedatives for ≥72 h
Methodological detailsinternational, multicentre, observational
- International
- Multicentre
- Observational
Main finding
As reported in the abstract
Regularly dosed parenteral opioids or sedatives for ≥72 h
Regularly dosed opioids, among those on opioids or sedatives ≥72 h
52.4%
Sedatives, among those on opioids or sedatives ≥72 h
56.4%
Observational data: associations, not effects.
Further findings
>50% dose reductions, <72 h vs ≥72 h
P < 0.001
Initiation of enteral medication, <72 h vs ≥72 h
P < 0.001
Continuous IV infusion
- Opioids
- 63.6%
- Sedatives
- 59.1%
Median 24-h total doses, ≥72 h vs <72 h
- Significantly higher in patients on opioids-sedatives for ≥72 h
- P < 0.030
Original publication
Patterns of opioid and sedative use in adult ICUs: Insights from the ALERT-ICU study on iatrogenic withdrawal syndrome. J Crit Care. Published 23 January 2026. doi:10.
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