scholarly journals Illicit Drug Use in the Pain Patient Population Decreases with Continued Drug Testing

2011 ◽  
Vol 3;14 (2;3) ◽  
pp. 189-193 ◽  
Author(s):  
Amadeo Pesce

Background: A major concern of physicians treating pain patients with chronic opioid therapy and similar drugs is determining whether the patients are also using illicit drugs. This is commonly determined by urine drug testing (UDT). However, there are few studies on whether or not monitoring patients by this technique decreases illicit drug use. Objective: To determine if the presence of illicit drugs decreases over a number of physician visits where UDT was performed. Method: The method involved a retrospective study of tests for the illicit drugs marijuana, cocaine, methamphetamine, ecstacy (MDMA) phencyclidine (PCP) and the heroin metabolite, 6-acetylmorphine as confirmed by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). A database of 150,000 patient visits was examined for the presence of any of these 6 drugs. Results: A total of 87,000 patients were initially tested. The number of patients who were repeatedly tested decreased over time. The percentage of patients positive for any of these illicit drugs decreased from 23% to 9% after 14 visits where UDT was performed. When graphed there was a trend to decreasing use. The Spearman correlation = -0.88, P < 0.0001. The major illicit drug was marijuana. When this was removed from the analysis, there was an even greater correlation with decreased illicit drug use. Spearman correlation = -0.92 (P < 0.0001) using a weighted correlation. Limitation: Patients continuing to use illicit drugs might be dismissed from practices thus biasing the study towards illicit drug avoidance. Conclusion: Continued UDT might decrease illicit drug use among pain patients. Key words: Pain patients, UDT, urine drug testing, LC-MS/MS, illicit drugs, decrease drug use

2017 ◽  
Vol 11 ◽  
pp. 117822181772478 ◽  
Author(s):  
Hope M Smiley-McDonald ◽  
Katherine N Moore ◽  
David C Heller ◽  
Jeri D Ropero-Miller ◽  
Gregory L McIntire ◽  
...  

This study is a 6-month retrospective analysis of urine drug testing (UDT) data from a pain management population among specimens with clinician-ordered marijuana testing (N = 194 809). Descriptive statistics about the specimen positivity of clinician-ordered marijuana UDT are provided as well as other drug positivity. Specimens from men and adults aged 18 to 34 years had the highest prevalence rates of marijuana positivity. The prevalence of past-month marijuana use among a comparative national population was lower than the prevalence of positive marijuana tests in the UDT specimens by all characteristics. Among the specimens tested for illicit drugs and marijuana, 4.0% were positive for amphetamine, 2.8% were positive for cocaine, and 0.9% were positive for heroin. The most common prescription drugs listed were opioids (64.7%), benzodiazepines (20.5%), and antidepressants (19.9%). In sum, the findings reflect previous research showing high rates of marijuana use, illicit drug use, and prescription drug use in a pain management population.


2008 ◽  
Vol 32 (8) ◽  
pp. 530-543 ◽  
Author(s):  
E. J. Cone ◽  
Y. H. Caplan ◽  
D. L. Black ◽  
T. Robert ◽  
F. Moser

2020 ◽  
Vol 3 (2) ◽  
pp. 15-29
Author(s):  
Sogo Angel Olofinbiyi ◽  
Thembelihle Mtambo

South African societies have been characterized by the prolific incidence of illicit drug use in recent times.  The paper attempts to examine the legislations implemented on the use of illicit drugs in South Africa. The study adopts a review of the literature to identify and describe the most common illicit drugs used around South Africa communities, placing emphasis on the policies developed by the South African government in combating these situations. The research follows a critical   discussion on the issues associated with drug use, its causes, as well as its effects on humans and the environment. The study recommends relevant initiatives to combat all intricacies associated with drug use within the country. This approach will be appropriate in facilitating a clear-cut   understanding of the possible remedies to quench the burning flame of illicit drug use across a broad range of South African communities.


Perfusion ◽  
2021 ◽  
pp. 026765912110281
Author(s):  
Chrissa Sioka ◽  
Georgios Georgiou ◽  
Christos Katsouras ◽  
Konstantinos Pappas ◽  
Dimitris-Nikiforos Kiortsis ◽  
...  

Patients with illicit drug use may have deleterious acute and chronic cardiac effects. We present a case of a 42-year-old man, former alcohol and various illicit drugs user, who was admitted to the psychiatric unit for management of psychosis. Because of his previous drug and alcohol history, a cardiological evaluation was performed which revealed silent severe myocardial ischemia detected by myocardial perfusion imaging (MPI). The myocardial ischemia was attributed to coronary microvascular dysfunction, occurring several years after quitting the illicit drugs. This study highlights the potential myocardial ischemia that may occur in patients with previous alcohol and illicit drug use, and the role of MPI, a non-invasive test that can provide important information regarding the myocardial status of such patients, even without obvious cardiac symptoms or findings.


2018 ◽  
Vol 64 (2) ◽  
pp. 114-118
Author(s):  
Rafael Alves Guimarães ◽  
Márcia Maria de Souza ◽  
Karlla Antonieta Amorim Caetano ◽  
Sheila Araujo Teles ◽  
Marcos André de Matos

Summary Objective: To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Method: Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Results: Of the total participants (n=105), 27.6% (95CI 20.0-36.9%) had used illicit drugs such as marijuana, cocaine, crack, LSD and inhalants. The consumption of these substances was associated with male gender, use of body piercing and/or tattoos, licit drug use and self-report of signs and/or symptoms of sexually transmitted infections. Conclusion: High prevalence of illicit drug use was found in the individuals investigated, ratifying the presence of risk factors to the vulnerability of the settlers to use these substances in the urban settlement population.


2019 ◽  
Vol 68 (1) ◽  
pp. 8-15
Author(s):  
Lauro Miranda Demenech ◽  
Samuel C. Dumith ◽  
Luiza Santos Ferreira ◽  
Mariana Lima Corrêa ◽  
Pedro San Martin Soares ◽  
...  

ABSTRACT Objective: To measure the prevalence of illicit drugs use in the lifetime, last year and last month, as well as the factors associated to the last year's use and its association with academic migration, among undergraduate students of a university in southern Brazil. Methods: In this cross-sectional study, data were collected through self-administered questionnaire. It was conducted a clustered systematic sampling. For multivariate analyses, it was used Poisson regression. Results: 1,423 students participated. The prevalence of illicit drug use in the lifetime, last year and last month were 42.4%, 25.5% and 17.7%, respectively. Regarding illicit substances, marijuana use was the most prevalent. The variables independently associated with illicit drugs use in the last year were academic migration, being male, younger, single, high parent's educational level, living with peers, tobacco use in the last year, and having friend and relative that have used illicit drugs. Religious practice had a protective effect. Conclusion: Individuals who migrated from their cities to study at the university are more exposed to the main risk factors pointed out by this research and hence to the use of illicit drugs. Based on these results, we suggest that universities develop evaluation, prevention, treatment or referral strategies considering specific needs of this population


Author(s):  
Monica O. Kuteesa ◽  
Helen A. Weiss ◽  
Sarah Cook ◽  
Janet Seeley ◽  
Josephine N. Ssentongo ◽  
...  

Background: We determined the prevalence of and risk factors for alcohol misuse and illicit drug use among young Ugandans in fishing communities, a recognised “key population” for human immunodeficiency virus (HIV) infection. Methods: We conducted a cross-sectional survey among young people (15–24 years) in fishing communities in Koome, Uganda, in December 2017–July 2018. Using Audio-Assisted Self-Interviewing, we collected data on socio-demographic characteristics and alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT) and timeline follow-back calendar (TLFB). Blood samples were analysed for HIV, herpes simplex virus 2 (HSV2), and Phosphatidyl ethanol (PEth 16:0/18:1). Urine samples were analysed for illicit drugs. Results: Among 1281 participants (52.7% male, mean age 20 years), 659 (51.4%) reported ever drinking alcohol, 248 (19.4%) had 12-month-AUDIT ≥ 8, and 261 (20.5%) had whole-blood PEth 16:0/18:1 concentration ≥ 20 ng/mL, indicating significant consumption. In multivariable analyses, PEth 16:0/18:1 ≥ 20ng/mL, AUDIT ≥ 8 and binge drinking (≥6 standard drinks per drinking occasion in the previous month from TLFB) were all strongly associated with older age, low education, smoking, and HSV2. Illicit drug use prevalence was 5.2% and was associated with older age, low education, being single, and smoking. Conclusion: Levels of alcohol misuse were high among young people in fishing communities and associated with HSV2, a proxy for risky sexual behaviour. Alcohol and illicit drug harm reduction services and HIV prevention programs in Uganda should prioritise young fisherfolk.


2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Ellen F Eaton ◽  
Andrew O Westfall ◽  
Brandi McClesky ◽  
Cayce S Paddock ◽  
Peter S Lane ◽  
...  

Abstract Background Hospitalized persons who inject drugs are at a greater risk of adverse hospital outcomes including discharge against medical advice, inpatient illicit drug use, overdose, and death. However, there are limited data on the frequency and outcomes of these events in the United States. Methods This retrospective analysis included patients with injection-related infections receiving a protocol for injection drug use (IDU) at University of Alabama at Birmingham Hospital from 2016 to 2017. In-hospital IDU was suspected or reported drug usage plus confirmatory drug screen, and documented discharges “against medical advice” were deemed patient-directed discharges (PDD). We analyzed the frequency of and associations between in-hospital IDU, PDD, 30-day readmission, and deaths (between 2016 and 2019) using McNemar’s tests. Logistic regression models evaluated the association between PDD, in-hospital IDU, readmission, and death. Results Overall, 83 patients met inclusion criteria: 28 (34%) with in-hospital IDU, 12 (14%) PDD, 9 (11%) died, and 12 (14%) 30-day readmission. In-hospital IDU was significantly associated with PDD (P = .003), 30-day readmission (P = .005), and death (P = .0003). Patient-directed discharges and 30-day readmission were not significantly associated with death nor with each other. Conclusions In a cohort of patients receiving inpatient care for injection-related infections, illicit drug use, PDD, 30-day readmissions, and death were common. Furthermore, patients who use illicit drugs while hospitalized are significantly more likely to leave early, be readmitted, and/or die. We must design models of care that prevent adverse outcomes, including drug use and PDD, to reduce barriers to evidence-based treatment of infections.


2015 ◽  
Vol 28 (4) ◽  
pp. 577-589 ◽  
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Bryan Y. Choi

ABSTRACTBackground:Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA.Methods:The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts.Results:Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17–2.03), 2.75 (95% CI = 1.75–4.33), and 2.12 (95% CI = 1.45–3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58–3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE.Conclusions:Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.


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