Postoperative Opioid Pain Medication Usage Following Adult Tonsillectomy

ABSTRACT Introduction The purpose of this study was to determine if short-term, high-quantity opioid use following adult tonsillectomy in active duty military members results in opioid misuse, using a proxy measure of referrals to substance abuse rehabilitation programs. Materials and Methods An Institutional Review Board-approved retrospective chart review was performed of 741 active duty patients who underwent tonsillectomy between 2012 and 2017. Data collection included preoperative medications within 60 days of surgery, all postoperative opioid prescriptions up to 12 months following surgery, and referrals to substance abuse rehabilitation within a year of surgery. Results Out of 741 patients, 658 met inclusion criteria. Fifty-one percent were women and the average age was 26 years. Fifty-nine percent of patients received 5 mg/325 mg oxycodone/acetaminophen as their initial postoperative pain medication. The average number of opioid tablets prescribed was 70 ± 18. Ninety three percent of patients received at least 60 tabs. The refill rate within 30 days of tonsillectomy was 38.6%. In the year following surgery, 25.4% of patients received additional doses of outpatient opioids for other indications. Nineteen patients (2.9%) were referred for substance abuse treatment within 1 year of tonsillectomy: seventeen for alcohol abuse, one for marijuana, and one for alcohol/marijuana. There were no referrals for opiate misuse or abuse. Conclusion Short-term, high-quantity opioid treatment of post-tonsillectomy pain in active duty adults does not result in long-term opioid misuse, as measured by substance abuse treatment program referrals within a year after surgery. This finding supports the appropriateness of adequate short-term narcotic medication treatment. The long-term readiness of these patients appears unaffected by long-term opioid misuse or abuse. Even with this finding, there is an institutional shift to multi-modality pain management and appropriate opioid reduction to further mitigate the risk of opioid misuse. Extrapolation of these findings to all adult tonsillectomy patients should be done with caution, as there are several protective factors in the active duty population such as stable full-time employment with mandatory random drug screening.

Drug Court Recidivism in the Rural Midwest: A 3-Year Post-Separation Analysis

Substance abuse continues to be a pressing social problem in the United States today. As the country battles an opioid epidemic, many jurisdictions have adopted the problem-solving court model in response. These specialized courts, known as drug courts, offer a rehabilitative approach to offender management. Drug courts balance substance abuse rehabilitation with community-based supervision and operate with the philosophy that addressing the addiction will result in a decrease in criminal offending. The current study examines the recidivism rates for 50 participants who have been separated (i.e., completed or terminated) from one rural drug court program in the Midwest for at least 3 years. Findings indicate that successful completion of drug court is associated with decreases in misdemeanor offending, and more importantly, decreases in felony offending. While preliminary, the findings of this research provide support for the drug court model in the rural Midwest. Further research in this area is highly recommended.

The Effectiveness of Theraplay® as a Counseling Practice With Mothers and Their Children in a Substance Abuse Rehabilitation Residential Facility

Substance abuse in parents is damaging to their children and the family system as a whole. If family treatment is paired with substance abuse treatment for the parents, children have the possibility of having better attachment with their parents and thus increase general functioning skills and overall family well-being. This study examined the impact of Whole Family Theraplay as an effective play therapy treatment with mothers in recovery from substance abuse and their children with attachment issues in an inpatient substance abuse rehabilitation facility. Scores indicated that women/mothers had reduced symptoms of distress and improved their mental health functioning. Their children demonstrated improved interpersonal relationships, reduced interpersonal distress, and improvement in overall mental health functioning. The implications of this study were that by implementing Whole Family Theraplay, in addition to individual and group counseling in substance abuse treatment, subjects showed demonstrated improvement in attachment relationships and mental health outcomes.

Effect of Taijiquan Exercise on Rehabilitation of Male Amphetamine-Type Addicts

Taijiquan is a traditional Chinese sport that is classified as a moderate exercise. Recent studies have evaluated the effectiveness of Taijiquan in substance abuse rehabilitation. Objective. To test the rehabilitation effect of Taijiquan exercise in patients with amphetamine (ATS) drug dependence. Methods. The effect of Taijiquan intervention was tested by parallel control experiment: Taijiquan group (n = 38) and control group (n = 38). The factors between the experimental groups were the group (Taijiquan group and the control group), and the factors within the group were the test time (before and after intervention). Repeated measurement analysis of variance was used to compare the two groups, and the factors that may affect the results were included in the covariance. Results. Taijiquan exercise promoted the balance control ability of ATS dependent patients ( p = 0.014 , η2 = 0.064), increased the overall sense of health ( p = 0.029 , η2 = 0.100), vitality ( p = 0.030 , η2 = 0.056), and mental health ( p = 0.016 , η2 = 0.061), improved trait anxiety ( p = 0.028 , η2 = 0.053), and reduced drug craving ( p = 0.048 , η2 = 0.048). Conclusion. Taijiquan exercise is beneficial to the physical and mental recovery of dependent patients, and the physical and mental benefits of exercise may have an effect on drug craving, which is of the most important significance for addicts to quit drugs and prevent relapse. The study is registered on the Chinese Clinical Trial Registry (No. ChiCTR1800015777).