Buprenorphine use and disparities in access among emergency department patients with opioid use disorder: A cross-sectional study

Emergency medicine is an upcoming discipline that is still under development in many countries. Therefore, it is important to gain insight into the organization and patients presenting to the Emergency Department (ED). The aim of this cross-sectional study was to provide an epidemiological description of complaints and referrals of the patients visiting the ED of the Ruijin Hospital in Shanghai, China. A questionnaire was developed and completed for a convenience sample of all patients presenting to the Triage Desk of the ED. The study was performed in June 2008. A total of 2183 questionnaires were completed. The most common complaints were fever (15%), stomach/abdominal pain (15%), vertigo/dizziness (11%), and cough (10%). Following triage, patients were predominantly referred to an internist (41%), neurologist (14%), pulmonologist (11%), or general surgeon (9%). This study provides a better understanding of the reason for the ED visit and the triage system at the ED of the Ruijin Hospital. The results can be used in order to improve facilities appropriate for the specific population in the ED.

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Hypogonadism in opioid using males in an inner-city cohort: A cross-sectional study

Journal of Opioid Management ◽

10.5055/jom.2021.0624 ◽

2021 ◽

Vol 17 (2) ◽

pp. 135-144

Author(s):

Leen Wehbeh, MD ◽

Adrian S. Dobs, MD, MHS ◽

Todd T. Brown, MD, PhD

Keyword(s):

Drug Users ◽

Free Testosterone ◽

Cross Sectional Study ◽

Opioid Use Disorder ◽

Male Hypogonadism ◽

Abdominal Adiposity ◽

Sectional Study ◽

Opioid Use ◽

Cross Sectional ◽

Heroin Use

Objectives: The link between male hypogonadism and opioids is well-established, but whether there is a difference in the frequency of hypogonadism between heroin and methadone for treatment of opioid use disorder (OUD) has not been determined.Design: Cross-sectional.Setting, patients, and participants: Male drug users and nonusers matched for socioeconomic status between 18 and 65 years, recruited in Baltimore as part of the study of HIV, injection drug use, nutrition, and endocrinology (SHINE). Methods: Hypogonadism was defined as low free testosterone 50 pg/mL. Participants were categorized into three groups based on opioid use: (1) NONE, (2) methadone use as treatment of OUD (METHADONE), and (3) Heroin use (HEROIN). This third group was further divided to mild (MH), and heavy (HH) heroin use. We used multiple logistic regression to examine the association between hypogonadism and different groups.Results: The cohort consisted of 189 men, 94 percent black, average age 43 years, with high HIV (56 percent) and HCV (38 percent) prevalence. 24 percent had hypogonadism. Compared to NONE, there were higher odds of hypogonadism in METHADONE (aOR 3.46; 95 percent CI [1.34,8.93]; p = 0.01) but not in HEROIN. After dividing HEROIN into MH and HH, there were higher odds of hypogonadism in HH compared to NONE (aOR 3.27; 95 percent CI [1.12,9.53]; p = 0.03) but not in MH.Conclusions: Methadone used for treatment of OUD was associated with male hypogonadism similar to heavy heroin use. Targeted hypogonadism screening and treatment may be warranted in this population to reduce its health consequences such as sexual dysfunction, osteoporosis, and abdominal adiposity.

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