A retrospective chart review was conducted of patients with acute renal colic for the years 1993 and 1997, in order to compare analgesia ordering and administration practices before and after implementation of a nurse-managed, titrated intravenous (IV) narcotic policy. The study demonstrated a significant and sustained change in analgesia administration practices away from the intramuscular (IM) route in favour of the IV route. For renal colic, in 1993, 76% of patients received IM narcotic analgesia compared to 3% in 1997. In contrast, IV narcotic (with or without adjuvant NSAID) was used in 3% of the patients in 1993 compared to 95% in 1997.