1) To investigate the factors associated with increased opiate usage in the first 14 days of admission; 2) To evaluate the association between opiate usage in the first 14 days and hospital length of stay; 3) To measure the incidence of opiate usage during the outpatient follow up.

SAH is a leading cause of mortality and morbidity, often presenting with “the worst headache of life”. The headache can persist for days to weeks and is a cause of significant disability. Continuous usage of opiates fails to adequately attenuate severe headache in SAH patients. This inadequately controlled headache is one of the frequent causes of readmission, leading to an increase in healthcare cost; there are few studies and no guidelines on its management.

90% of patients were prescribed opiates during their hospitalization. Steroid usage was associated with an increase in 14-day opiate usage. Over 14 days, smokers significantly used more opiates compared to nonsmokers. Peri-mesencephalic SAH required less morphine compared to aneurysmal SAH. Aneurysm clipping was associated with less opiate usage compared to aneurysm coiling. 42% suffered from headaches during their outpatient follow up within 3 months of discharge, however only 5% were still on opiates. There was a significant association between the amount of opiate used in the first 14 days of admission and the rate of post discharge headache