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This case study explores limitations of using electronic health record (EHR) data from a hospital data lake by deriving indicators on opioid prescribing. A multi-staged method to calculate indicators of rational opioid use was developed covering both inpatient orders and outpatient prescriptions. The process included data selection, editing, organization, and validation. Visual Basic was employed to calculate indicators and to semi-quantify data limitations. Data (2015\u20132019) covered 3.3 million patients with 179,853 opioid and 22,415 benzodiazepine orders. Data quality issues, including unstructured, irregular, and invalid entries, limited analysis to indicators on opioid use and contraindications. In conclusion, secondary use should be considered in EHR system development. 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