scholarly journals Outcomes in patients with acute myocardial infarction and a history of illicit drug use: a nationwide analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Genet ◽  
I Ma ◽  
A Bisson ◽  
A Bodin ◽  
J Herbert ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Drug Use ◽  
Illicit Drug ◽  
Univariate Analysis ◽  
Illicit Drug Use ◽  
Opioid Use ◽  
Risk Of Death ◽  
History Of ◽  
One Year

Abstract Background Several reports suggest that illicit drug use may be a major cause of acute myocardial infarction (AMI) independently of smoking habits, and associated with a poorer prognosis. Purpose We sought to determine the frequency of history of illicit drug use in an AMI population and its impact on short- and mid-term prognosis. Methods Based on the administrative hospital-discharge database, we collected information for all patients treated with AMI between 2010 and 2018 in France. We identified patients with history of illicit drug use and the adverse outcomes were investigated during follow-up. Results Among 797,212 patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI (mean age 69 years, 66% male), 3827 patients (0.5%) had a known history of illicit drug use (cannabis, cocaine or opioid). Patients with illicit drug use were younger and had less comorbidities. They presented more frequently with STEMI and anterior localization compared to those with no history of illicit drug use. In univariate analysis, patients with illicit drug use had lower short-term mortality rates compared to those without history of illicit drug use: 4.9% vs 10.1% at one month (p<0.0001), respectively. However, this might be attributed to a younger age at the time of presentation. Using logistic multivariable analysis with adjustment on age, gender, other cardiovascular and non-cardiovascular comorbidities, type and localisation of MI and procedures of revascularization, history of illicit drug use was associated with a non-significant higher risk of death at one year (adjusted odds ratio OR 1.12 95% CI 0.98–1.29). This trend was supported by a significantly higher risk of death at one year in patients with a history of opioid use (OR 1.27 95% CI 1.04–1.29, p=0.01). Conclusion In a large and systematic nationwide analysis of patients with AMI, history of illicit drug use was associated with a non-significant higher overall odds of mortality, which was significant among those with opioid use. Funding Acknowledgement Type of funding source: None

scholarly journals Outcomes in patients with acute myocardial infarction and a history of illicit drug use

2022 ◽  
Vol 14 (1) ◽  
pp. 8
Author(s):  
I. Ma ◽  
T. Genet ◽  
N. Clémenty ◽  
A. Bisson ◽  
J. Herbert ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
History Of

scholarly journals Urine Screening for Opiod and Illicit Drugs in the Total Joint Arthroplasty Population

2020 ◽  
Vol 13 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Matthew Vopat ◽  
William Messamore ◽  
Jesse Trent ◽  
Ken Schmanke ◽  
Rosey Zackula ◽  
...  
Keyword(s):  
Drug Use ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Joint Arthroplasty ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Number Of Patients ◽  
Patient Reported ◽  
History Of

Introduction. Recent studies have shown an increase in post-operative orthopaedic complications associated with pre-operative opioid use. It is, therefore, important to know if patients use opioids before scheduled surgery. The purpose of this study was to determine if urine drug screening (UDS) is an effective screening tool for detecting opioid and illicit drug use prior to joint arthroplasty (JA) procedures. Methods. This retrospective chart review was performed with IRB approval on 166 out of 172 consecutive patients in a community-based practice. All the patients had a pre-operative UDS prior to primary or revision JA by a fellowship trained orthopaedic surgeon between March 2016 and April 2017. Patient demographics documented opioid and illicit drug use, co-morbid diagnosis, and UDS results were collected from clinical charts. Statistical analysis was conducted using Pearson Chi-square, Fisher’s exact, McNemar test, and t-tests with IBM SPSS Statistics, ver. 23. Significant differences were p < 0.05. Results. Sixty-four of 166 patients (38.6%) tested positive for opioids. Among them, 55.0% (35/64) had no history of prescription opioid use. Significant differences were observed when comparing the test results of the UDS with the patient reported history of prescribed opioids (p = 0.001). Conclusion. With a significant number of patients testing positive for opioids without evidence of a previous prescription, UDS may be beneficial for initial risk assessment for patients undergoing JA procedures.

Storage, disposal, and utilization of opioids among cancer outpatients.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 222-222
Author(s):  
Akhila Sunkepally Reddy ◽  
Maxine Grace Jaucian De La Cruz ◽  
Eden Mae Rodriguez ◽  
Jessica Thames ◽  
Jimin Wu ◽  
...  
Keyword(s):  
Drug Use ◽  
Adult Children ◽  
Illicit Drug ◽  
Care Center ◽  
Illicit Drug Use ◽  
Patient Characteristics ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Never Married ◽  
History Of

222 Background: Prescription opioid abuse is an epidemic in the US. Of the abusers, 75% obtain the opioid from a friend or relative, which may be related to improper opioid storage and disposal practices. Our aim was to determine patients’ practices of opioid use, storage, and disposal. Methods: We surveyed 300 cancer outpatients presenting to our Supportive Care Center who were receiving opioids for at least 1 month and collected information regarding opioid use, storage, and disposal along with patient characteristics and scores on Cut-down, Annoyed, Guilty, Eye-opener (CAGE) questionnaire for alcoholism. Sharing or losing their opioids was defined as an unsafe use. Results: The median age of the patients was 57 years; 53% were female, 72% were white, and 63% were married. Most (89%) had advanced cancer, and lung cancer was the most common (22%). CAGE was positive in 19%, 9% had history of illicit drug use, and 36% lived with adult/young adult children. Of the 300 respondents, 19% stored opioids in the open, 69% kept opioids hidden but unlocked, and 9% locked their opioids. Patients with history of CAGE positivity (P=.007), illicit drug use (.0002), smoking (P=.03), and those living with adult children (P=.004) were more likely to keep their opioids locked. 66% were unaware of proper opioid disposal methods. 46% had unused opioids at home. 53% did not routinely dispose opioids, of whom 44% saved them for future use. 26% indulged in unsafe use by sharing (9%) or losing (17%) their opioids, and 44% informed their family and friends that they were on pain medications. 39% were unaware that their opioid could be fatal when taken by others. Compared with married patients, those who were never married [OR=2.92; 95% CI 1.48-5.77], separated [OR=11.38; 1.52-112.5], or divorced [OR=1.27; 0.55-2.91] had higher odds of unsafe use (P=.006). CAGE positivity (40% vs. 21%, P=.003) and illicit drug use (42% vs. 23%, P=.031) were also significant predictors of unsafe use. Conclusions: An alarming proportion of patients improperly and unsafely use, store, and dispose of opioids. Patient education by physicians/pharmacists and creation of more drug take back programs may reduce availability of prescription opioids for potential abuse. More research is needed in this area.

Treatment patterns in women seeking care for endometriosis at an endometriosis center

2021 ◽  
pp. 228402652110456
Author(s):  
Katharine E Linder ◽  
Tatnai L Burnett ◽  
Chia-Sui Weng ◽  
Zaraq Khan ◽  
Kristin Mara ◽  
...  
Keyword(s):  
Drug Use ◽  
Pelvic Pain ◽  
Significant Relationship ◽  
Illicit Drug ◽  
Pelvic Floor Dysfunction ◽  
Illicit Drug Use ◽  
Surgical Excision ◽  
Hormonal Contraceptives ◽  
Opioid Use ◽  
Prior Surgery

Objective: To determine the clinical characteristics and prior medical and surgical treatments in women undergoing surgical excision of endometriosis for pelvic pain at a single institution. Methods: In this retrospective cohort study we identified 140 women with pathology-proven endometriosis who completed a preoperative standardized pain form and underwent surgery at an endometriosis center. Women were stratified into three groups for analysis: no prior surgery, 1 prior surgery, and 2+ prior surgeries. Results: The most common treatments used prior to seeking care were hormonal contraceptives (51.6%) and surgery (46.1%). More than half of women were diagnosed with pelvic floor dysfunction at time of presentation or prior to consultation. There was a significant relationship between an increasing number of surgeries (none vs 1 vs 2+) and gonadotropin-releasing hormone (GnRH) agonist use (19.0% vs 27.5% vs 56.0%, p = 0.003). Though not significant, a trend was noted between increasing surgeries and opioid use (20.6% vs 30.0% vs 40.0%, p = 0.17). There was a statistically significant relationship between multiple surgeries and illicit drug use ( p < 0.001). Conclusion: Patients with pelvic pain and endometriosis who have undergone multiple surgeries are more likely to have used GnRH agonists and report illicit drug use prior to presenting to specialized care.

Outcomes of coronary artery bypass grafting in patients with a history of illicit drug use

2003 ◽  
Vol 92 (5) ◽  
pp. 593-595 ◽  
Author(s):  
Praphul Misra ◽  
Gloria C. Caldito ◽  
Aman K. Kakkar ◽  
Mary C. Mancini ◽  
Pratap C. Reddy
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Drug Use ◽  
Coronary Artery Bypass ◽  
Illicit Drug ◽  
Artery Bypass ◽  
Illicit Drug Use ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
History Of

Association between tobacco use and symptom expression, alcoholism, and illicit drug use in patients with advanced cancer.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 154-154
Author(s):  
YuJung Kim ◽  
Rony Dev ◽  
Akhila Sunkepally Reddy ◽  
David Hui ◽  
Gary B. Chisholm ◽  
...  
Keyword(s):  
Drug Use ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Advanced Cancer Patients ◽  
Pain Expression ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

154 Background: Our aim was to determine the association between smoking status and symptom expression, opioid use, alcoholism, and illicit drug use in advanced cancer patients. Methods: We retrospectively reviewed 560 consecutive charts from the outpatient Supportive Care Center and identified 300 advanced cancer patients who completed a comprehensive smoking questionnaire. Data on the Edmonton Symptom Assessment Scale (ESAS), morphine equivalent daily dose (MEDD), CAGE (Cut Down, Annoyed, Guilty, Eye Opener) questionnaire for alcoholism screening, and history of illicit drug use were collected. Results: Among 300 advanced cancer patients, 119 (40%) were never-smokers, 148 (49%) were former smokers, and 33 (11%) were current smokers. Compared with never-smokers, current smokers were more likely to be men (58% vs. 29%, P=0.004), report a higher pain expression (median 7.0 vs. 5.0 by the ESAS, P=0.007), be CAGE positive (≥2 yes response) (42% vs. 3%, P<0.001), and have a history of illicit drug use (33% vs. 3%, P<0.001). Compared with never-smokers, former smokers were more likely to be men (60% vs. 29%, P<0.001), have head and neck cancer or lung cancer (30% vs. 13%, P=0.001), be CAGE positive (21% vs. 3%, P<0.001), and have a history of illicit drug use (16% vs. 3%, P<0.001). Current smokers reported a higher pain expression than former smokers (median 7.0 vs. 6.0 by the ESAS, P=0.01), had higher CAGE positivity (42% vs. 21%, P=0.01) and more frequent illicit drug use (33% vs. 16%, P=0.03). The MEDD and the timing of palliative care referral were not significantly different between current or former smokers compared with never-smokers. However, a higher proportion of current smokers were receiving opioids with MEDD ≥30mg at the time of palliative care consultation compared with never-smokers (70% vs. 52%, P=0.08). Conclusions: Our study suggests that current tobacco use is associated with a higher pain expression. In addition, any history of tobacco use is associated with a history of illicit drug use and alcoholism. Advanced cancer patients who smoked cigarettes may be at an increased risk for chemical coping or stronger opioid utilization and further studies are needed.

scholarly journals Auditory skill analysis of a group of subjects with history of illicit drug use

2009 ◽  
Vol 75 (5) ◽  
pp. 685-693
Author(s):  
Daniela de Lucas Rosseto ◽  
Silvana Cristina Ribeiro ◽  
Mônica Pires de Castro Mendonça ◽  
José Antônio A. de Oliveira ◽  
Ana Cláudia Mirândola Barbosa Reis ◽  
...  
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
History Of ◽  
Skill Analysis

Testing a General Theory of Drug Abuse and other Deviant Adaptations

1985 ◽  
Vol 15 (4) ◽  
pp. 477-492 ◽  
Author(s):  
Howard B. Kaplan
Keyword(s):  
Drug Use ◽  
General Theory ◽  
Illicit Drug ◽  
Deviant Behavior ◽  
Multivariate Analyses ◽  
Illicit Drug Use ◽  
The Self ◽  
Social Evaluation ◽  
Level Of Involvement ◽  
History Of

I present an outline of the current state of an evolving general theory of deviant behavior, particularly as it applies to the explanation of the onset and continuity or change in level of involvement in illicit drug use. Self-derogation remains a central organizing concept in the theory. The need for self-approval disposes a person to illicit drug use, depending upon the social evaluation of this pattern in the person's membership/reference groups and the history of net self-enhancing/self-devaluing experiences in these groups. The initiation of illicit drug use is a function of circumstances influencing the opportunities for, and the self-evaluative relevance of anticipated consequences of, the illicit drug use. The continuity of the illicit drug use is a function of the self-evaluative relevance of the perceived consequences of initial drug use, and of changes in the circumstances that provide opportunities for and redefine the self-evaluative relevance of normative standards. The results of recent multivariate analyses are described. These results point to the usefulness of the theory both as a guide for research and as a framework for integrating the results of multivariate analyses estimating the onset and continuity or changes in level of involvement in illicit drug use.

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