Non‐medical prescription opioid use and in‐hospital illicit drug use among people who use drugs

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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.222 ◽

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.

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Non-medical prescription opioid use among youth: Gaining perspective from decades of previous drug use epidemics

International Journal of Drug Policy ◽

10.1016/j.drugpo.2015.06.004 ◽

2016 ◽

Vol 27 ◽

pp. 184-185

Author(s):

Tessa Cheng ◽

Kora DeBeck ◽

Will Small

Keyword(s):

Drug Use ◽

Prescription Opioid ◽

Opioid Use ◽

Medical Prescription ◽

Prescription Opioid Use

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

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.1177/22840265211045606 ◽

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.

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