Articles: opioid.
-
Preventive medicine · Aug 2022
Effect of HCV or HIV infection on mortality among hospitalized persons who used opioids, 2000-2010.
Mortality due to opioid misuse and overdose has increased substantially in the United States over the past two decades. The study objective was to describe the causes of death among persons with opioid-related hospitalizations and examine survival by Hepatitis C virus (HCV) or HIV. Opioid-related hospitalization records in Pennsylvania from 2000 to 2010 were linked to death registry files to assess cause of death, and survival from first hospital discharge date to death date, or December 31, 2010. ⋯ Patients with HIV also had shorter survival time (time ratio: 0.29 [95% CI: 0.26, 0.34]) compared to without HIV. These findings show that in a cohort of patients with opioid-related hospitalizations, those with HCV or HIV diagnoses have shorter survival. This has public health implications, providing further evidence that medical providers should educate patients who use opioids about the risks of HCV and HIV infection and focus prevention and treatment to decrease mortality among patients hospitalized for opioid use.
-
Transgender veterans have a high prevalence of substance use disorder and physical and mental-health comorbidities, which are associated with prescription opioid use and overdose risk. This study compares receipt of outpatient opioids, high-risk opioid prescribing, and opioid poisoning between transgender and cisgender (i.e., nontransgender) veterans. ⋯ Transgender veterans had a greater risk of being prescribed an outpatient opioid than cisgender veterans but did not have different risks of high-risk opioid prescribing.
-
Patients with injury may be at high risk of long-term opioid use due to the specific features of injury (e.g., injury severity), as well as patient, treatment, and provider characteristics that may influence their injury-related pain management. ⋯ Across this large cohort of multiple, mostly minor, injury types, long-term opioid use was relatively uncommon, but almost all patients with chronic use post injury had preinjury opioid use. Long-term opioid use after injury may be more closely tied to preinjury chronic pain and pain management than acute care pain management.
-
Preoperative exposure to opioids has recently shown to be associated with poor outcomes after elective major surgery, but little is known as to how pretreatment opioid use affects results of interventional back pain management. ⋯ Pretreatment opioid use is associated with greater pain discomfort, impairment, and reduced functional ability, as well as poorer long-term effect of interventional back pain treatment at one-month follow-up. In our study, opioid users reported the same positive effects of facet joint nerve blocks immediately after the treatment and 2 hours after the treatment, but a significantly smaller effect at one-month follow-up. This could indicate that opioid use may diminish the effects of pain treatments by affecting relearning, behavioral changes, and central pain modulation. These findings may help providers understand the effect of pretreatment opioid use on patient care, and its implications on hospital and societal costs.