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Individual practices vary. You may go to another ER and find they treat migraines completely differently. I tend to not use opioids for migraines after the patient has failed non-opioid treatments, others use opioids as first line therapy. Also depends on the patient - some patients go to the ER and say "only xxx works for my 'migraines'" and have the expectation that they will get whatever they demand. If I am busy and don't have time to discuss the issue of narcotic rebound headaches, I will just given them their shot, discharge them, and move on.

Sometimes, it depends on throughput.

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Q: Why is nubain the common injection used for the acute treatment of migraines in the ER versus other opioids?
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