scholarly journals Impact of adherence to antidepressants on long-term prescription opioid use cessation

2018 ◽  
Vol 212 (2) ◽  
pp. 103-111 ◽  
Author(s):  
Jeffrey F. Scherrer ◽  
Joanne Salas ◽  
Mark D. Sullivan ◽  
Brian K. Ahmedani ◽  
Laurel A. Copeland ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Opioid Analgesic ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Inverse Probability ◽  
Prescription Refill ◽  
Weighted Data ◽  
Prescription Opioid Use ◽  
Analgesic Use

BackgroundDepression contributes to persistent opioid analgesic use (OAU). Treating depression may increase opioid cessation.AimsTo determine if adherence to antidepressant medications (ADMs) v. non-adherence was associated with opioid cessation in patients with a new depression episode after >90 days of OAU.MethodPatients with non-cancer, non-HIV pain (n = 2821), with a new episode of depression following >90 days of OAU, were eligible if they received ≥1 ADM prescription from 2002 to 2012. ADM adherence was defined as >80% of days covered. Opioid cessation was defined as ≥182 days without a prescription refill. Confounding was controlled by inverse probability of treatment weighting.ResultsIn weighted data, the incidence rate of opioid cessation was significantly (P = 0.007) greater in patients who adhered v. did not adhered to taking antidepressants (57.2/1000 v. 45.0/1000 person-years). ADM adherence was significantly associated with opioid cessation (odds ratio (OR) = 1.24, 95% CI 1.05–1.46).ConclusionsADM adherence, compared with non-adherence, is associated with opioid cessation in non-cancer pain. Opioid taper and cessation may be more successful when depression is treated to remission.Declaration of interestNone.

scholarly journals Prescription Opioid Analgesic Use and Mortality in Systemic Lupus Erythematosus

2018 ◽  
Author(s):  
Romy J. Cabacungan ◽  
Clifford R. Qualls ◽  
Wilmer L Sibbitt ◽  
William A. Hayward ◽  
James I. Gibb ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
Hazard Ratio ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Systemic Lupus ◽  
Probability Of Death ◽  
Prescription Opioid Use ◽  
Analgesic Use

AbstractObjectivesThis research investigated the prevalence of opioid analgesic use in patients with systemic lupus erythematosus (SLE).MethodsThis 5-year prospective cohort study of 275 SLE patients focused on prescription opioid use and 5-year outcome. Associations were determined with univariable regression analysis and then multivariable models were created to determine independent effects on dependent variablesResultsPrescription opioid use was common in SLE with 24% using opioid analgesics chronically and 76% not using opioids. Opioid users had a higher rate of tobacco use (p<0.01), cocaine use (p<0.002), mean pain scores (p<0.001), disease activity (SLEDAI-2K) (p<0.001), disease damage (SLICC/ACRDI) (p<0.001), non-adherence to medical therapy (p<0.01), and total deaths at 5 years (opioids: 48.0%, no opioids 19.0%, p<0.001). Logistic regression analysis predicting death revealed opioid use (hazard ratio 2.6, p<0.001) and SLEDAI-2K (1.1, p<0.001) respectively; and opioid use (hazard ratio 2.5, p<0.002), SLEDAI-2K (hazard ratio 1.1, p<0.001), and non-adherence (hazard ratio 1.6, p=0.11), respectively. Multivariable Cox Model analysis estimating probability of death with covariates: opioid use (hazard ratio 2.6, p<0.001) and SLEDAI-2K (hazard ratio 1.1, p<0.001); opioid use (hazard ratios 3.0, p<0.001), and cocaine use (hazard ratio 3.2, p<0.001). The Kaplan-Meir survival analysis revealed a significantly higher probability of death for SLE patients using opioid analgesics.ConclusionsPrescription opioid analgesic use is common in SLE and is associated with markedly increased mortality. Preferably, non-opioid approaches to treat chronic pain should be used in SLE patients.Clinical trial registration numberThis was not a clinical trial.KEY MESSAGES:1. Chronic opioid analgesic use is common in SLE (24%).2. Opioid use is associated with greater disease severity, tobacco use, non-adherence, and increased mortality.3. Opioids should be used cautiously in SLE; alternative non-opioid management of pain is recommended.ACKNOWLEDGMENTS AND FUNDING INFORMATION:This work was supported by US National Institutes of Health research grants to Dr. Sibbitt (R01 NS035708) and to the Clinical and Translational Research Center (UL1TR001449).

Prescription opioid use during pregnancy and risk for preterm birth or term low birthweight

2021 ◽  
Vol 17 (3) ◽  
pp. 215-225
Author(s):  
Julia D. Interrante, MPH ◽  
Stacey L. P. Scroggs, PhD ◽  
Carol J. Hogue, PhD ◽  
Jan M. Friedman, MD ◽  
Jennita Reefhuis, PhD ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Low Birthweight ◽  
Opioid Analgesic ◽  
Population Based ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Increased Risk ◽  
Potential Risks ◽  
Prescription Opioid Use

Objective: Examine the relationship between prescription opioid analgesic use during pregnancy and preterm birth or term low birthweight.Design, setting, and participants: We analyzed data from the National Birth Defects Prevention Study, a US multisite, population-based study, for births from 1997 to 2011. We defined exposure as self-reported prescription opioid use between one month before conception and the end of pregnancy, and we dichotomized opioid use duration by ≤7 days and 7 days.Main outcome measures: We examined the association between opioid use and preterm birth (defined as gestational age 37 weeks) and term low birthweight (defined as 2500 g at gestational age ≥37 weeks).Results: Among 10,491 singleton mother/infant pairs, 470 (4.5 percent) reported opioid use. Among women reporting opioid use, 236 (50 percent) used opioids for 7 days; codeine (170, 36 percent) and hydrocodone (163, 35 percent) were the most commonly reported opioids. Opioid use was associated with slightly increased risk for preterm birth [adjusted odds ratio, 1.4; 95 percent confidence interval, 1.0, 1.9], particularly with hydrocodone [1.6; 1.0, 2.6], meperidine [2.5; 1.2, 5.2], or morphine [3.0; 1.5, 6.1] use for any duration; however, opioid use was not significantly associated with term low birthweight.Conclusions: Preterm birth occurred more frequently among infants of women reporting prescription opioid use during pregnancy. However, we could not determine if these risks relate to the drug or to indications for use. Patients who use opioids during pregnancy should be counseled by their practitioners about this and other potential risks associated with opioid use in pregnancy. 

scholarly journals Factors Associated with Prescription Opioid Analgesic Use in the US Population, 2011–2014

Pain Medicine ◽  
2018 ◽  
Vol 20 (7) ◽  
pp. 1338-1346 ◽  
Author(s):  
Steven M Frenk ◽  
Susan L Lukacs ◽  
Qiuping Gu
Keyword(s):  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Factors Associated ◽  
The Past ◽  
The Us ◽  
Opioid Users ◽  
Analgesic Use

Abstract Objective This study examined factors associated with prescription opioid analgesic use in the US population using data from a nationally representative sample. It focused on factors previously shown to be associated with opioid use disorder or overdose. Variations in the use of different strength opioid analgesics by demographic subgroup were also examined. Methods Data came from respondents aged 16 years and older who participated in the National Health and Nutrition Examination Survey (2011–2014). Respondents were classified as opioid users if they reported using one or more prescription opioid analgesics in the past 30 days. Results Opioid users reported poorer self-perceived health than those not currently using opioids. Compared with those not using opioids, opioid users were more likely to rate their health as being “fair” or “poor” (40.4% [95% confidence interval {CI} = 34.9%–46.2%] compared with 15.6% [95% CI = 14.3%–17.1%]), experienced more days of pain during the past 30 days (mean = 14.3 [95% CI = 12.9–15.8] days compared with 2.3 [95% CI = 2.0–2.7] days), and had depression (22.5% [95% CI = 17.3%–28.7%] compared with 7.1% [95% CI = 6.2%–8.0%]). Among those who reported using opioids during the past 30 days, 18.8% (95% CI = 14.4%–24.1%) reported using benzodiazepine medication during the same period and 5.2% (95% CI = 3.5%–7.7%) reported using an illicit drug during the past six months. When opioid strength was examined, a smaller percentage of adults aged 60 years and older used stronger-than-morphine opioids compared with adults aged 20–39 and 40–59 years. Conclusions Higher percentages of current opioid users than nonusers reported having many of the factors associated with opioid use disorder and overdose.

scholarly journals Gender and the Association between Long-Term Prescription Opioid Use and New-Onset Depression

2018 ◽  
Vol 19 (1) ◽  
pp. 88-98 ◽  
Author(s):  
Joanne Salas ◽  
Jeffrey F. Scherrer ◽  
Brian K. Ahmedani ◽  
Laurel A. Copeland ◽  
Kathleen K. Bucholz ◽  
...  
Keyword(s):  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use ◽  
New Onset

A Risk Prediction Model for Long-term Prescription Opioid Use

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Iraklis E. Tseregounis ◽  
Daniel J. Tancredi ◽  
Susan L. Stewart ◽  
Aaron B. Shev ◽  
Andrew Crawford ◽  
...  
Keyword(s):  
Prediction Model ◽  
Risk Prediction ◽  
Risk Prediction Model ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

scholarly journals Social vulnerability in persons with chronic hepatitis C virus infection is associated with a higher risk of prescription opioid use

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeel A. Butt ◽  
Peng Yan ◽  
Shashi Kapadia ◽  
Abdul-Badi Abou-Samra ◽  
Naveed Z. Janjua ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Social Vulnerability ◽  
Prescription Opioid ◽  
Hepatitis C Virus Infection ◽  
Opioid Use ◽  
Vulnerability Factors ◽  
Chronic Hepatitis C Virus ◽  
Prescription Opioid Use

AbstractPrescription opioid use (POU) is often a precursor to opioid use disorder (OUD) and subsequent consequences. Persons with chronic hepatitis C virus infection (CHC) may be at a higher risk of POU due to a higher comorbidity burden and social vulnerability factors. We sought to determine the burden of POU and associated risk factors among persons with CHC in the context of social vulnerability. We identified CHC persons and propensity-score matched HCV− controls in the electronically retrieved Cohort of HCV-Infected Veterans and determined the frequency of acute, episodic long-term and chronic long-term POU and the prevalence of social vulnerability factors among persons with POU. We used logistic regression analysis to determine factors associated with POU. Among 160,856 CHC and 160,856 propensity-score matched HCV-controls, acute POU was recorded in 38.4% and 38.0% (P = 0.01) respectively. Episodic long-term POU was recorded in 3.9% in each group (P = 0.5), while chronic long-term POU was recorded in 28.4% and 19.2% (P < 0.0001). CHC was associated with a higher risk of chronic long-term POU (OR 1.66, 95%CI 1.63, 1.69), but not with acute or episodic long-term POU. Black race, female sex and homelessness were associated with a higher risk of chronic long-term POU. Presence of ≥ 1 factor was associated with a higher risk of all POU patterns. Persons with CHC have more social vulnerability factors and a higher risk of chronic long-term POU. Presence of ≥ 1 social vulnerability factor is associated with a higher risk of POU. Downstream consequences of POU need further study.

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