Objective: To analyze the application of opioids during 2021-2023 in the inpatients in the first affiliated hospital of Hebei north university, and to evaluate rationality of opioids use, so as to provide reference for promoting the rational use of opioids in the first affiliated hospital of Hebei north university. Methods：To refer to the application of opioids between January 2021 and December 2023 in the inpatients of the first affiliated hospital of Hebei north university. Graph Pad Prism 8 software was used to retrospective analyze and evaluate that the consumption volume, consumption sum, DDDs, DDC, B/A, distribution of departmental and disease use of opioids. Graph Pad Prism 8 software was used for linear regression analysis, and the trend of drug use with each year was estimated according to the regression coefficient of the mode. SPSS 18.0 software was used to analyze the chisquare test for quantitative indicators. Results：Thirteen opioids were included in this study. The top 5 opiods in the list of consumption volume were Oxycodone hydrochloride sustained-release tablets (40 mg), Morphine sulfate sustained-release tablets, Bucinnazine hydrochloride injection, Compound platycodon tablets and Oxycodone hydrochloride sustained-release tablets (10 mg) of the first affiliated hospital of Hebei north university during 2021-2023. The use of oral dosage forms, injectable dosage forms, and patches of opioids increased yearly and were considered as statistically significant(P<0.05). Oxycodone hydrochloride sustained-release tablets (40 mg) consumption ratio trends upward. The top 3 opiods in the list of DDDs were Oxycodone hydrochloride sustained-release tablets (40 mg), Morphine sulfate sustained-release tablets and Bucinnazine hydrochloride injection of the first affiliated hospital of Hebei north university during 2021-2023. Opioids DDDs were in an increasing trend (β>0) and were considered as statistically significant (P<0.05), except for codeine phosphate tablets, morphine hydrochloride tablets, Bucinnazine hydrochloride tablets. The top 5 opiods in the list of consumption sum were Oxycodone hydrochloride sustained-release tablets (40 mg), Morphine sulfate sustainedrelease tablets, Oxycodone hydrochloride sustained-release tablets (10 mg), Fentanyl Citrate Injection and Remifentanil hydrochloride for Injection of our hospital during 2021-2023. Opioids consumption sum were in an increasing trend (β>0) and were considered as statistically significant (P<0.05), except for codeine phosphate tablets, morphine hydrochloride tablets, Bucinnazine hydrochloride tablets. All of opioids DDC trends upward during 2021-2023. Remifentanil Hydrochloride for Injection, Oxycodone hydrochloride sustained-release tablets (10 mg) and Oxycodone hydrochloride sustained-release tablets (40 mg) DDC were consistently above 60. Bucinnazine hydrochloride Injection, Codeine phosphate tablets, Bucinnazine hydrochloride tablets and compound platycodon tablets B/A were above 1.00, Fentanyl Citrate Injection B/A were above 2.00. Other opioids B/A remained largely unchanged at 0.00~1.50. Chinese medicine, medical oncology, and respiratory and critical care medicine departments frequently uesd opiods during 2021-2023. Tumors used opioids Most, and lung cancer had highest use rate of opioids. Conclusion：Consumption volume, DDDs, consumption sum and DDC of opioids of the first affiliated hospital of Hebei north university were increasing yearly. Patients with tumors was a major group of opioid users. We should deeply study pharmacogenomics and realize individualized medication of opioids. To select the appropriate drug for the patient in order to use the drug accessibility, safety, and effectiveness.