The Impact of Opioid Use on Human and Healthcare Costs in Surgical Patients

2019 ◽  
Author(s):  
Al-Faraaz Kassam ◽  
Young Kim ◽  
Alexander R. Cortez ◽  
Vikrom K. Dhar ◽  
Koffi Wima ◽  
...  
Keyword(s):  
Healthcare Costs ◽  
Surgical Patients ◽  
Opioid Use ◽  
The Impact

scholarly journals The impact of opioid use on human and health care costs in surgical patients

2020 ◽  
Vol 2 (2) ◽  
pp. 92-95
Author(s):  
Al-Faraaz Kassam ◽  
Young Kim ◽  
Alexander R. Cortez ◽  
Vikrom K. Dhar ◽  
Koffi Wima ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Surgical Patients ◽  
Opioid Use ◽  
The Impact ◽  
Care Costs

scholarly journals Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs

2021 ◽  
Vol 11 (11) ◽  
pp. 1174
Author(s):  
Veronique Michaud ◽  
Ravil Bikmetov ◽  
Matt K. Smith ◽  
Pamela Dow ◽  
Lucy I. Darakjian ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Risk Score ◽  
Healthcare Costs ◽  
Claims Data ◽  
Cohort Analysis ◽  
Medical Expenditure ◽  
Opioid Use ◽  
Medication Risk ◽  
Opioid Users ◽  
The Impact

Cytochrome P450 2D6 (CYP2D6) activity is highly variable due to several factors, including genetic polymorphisms and drug-drug-gene interactions. Hydrocodone, oxycodone, codeine, and tramadol the most commonly prescribed CYP2D6-activated opioids for pain. However, the co-administration of CYP2D6 interacting drugs can modulate CYP2D6-medicated activation of these opioids, affecting drug analgesia, effectiveness, and safety, and can impact healthcare costs. A retrospective, observational cohort analysis was performed in a large (n = 50,843) adult population. This study used drug claims data to derive medication risk scores and matching propensity scores to estimate the effects of opioid use and drug-drug interactions (DDIs) on medical expenditures. 4088 individuals were identified as opioid users; 95% of those were prescribed CYP2D6-activated opioids. Among those, 15% were identified as being at risk for DDIs. Opioid users had a significant increase in yearly medical expenditure compared to non-opioid users ($2457 vs. $1210). In matched individuals, average healthcare expenditures were higher for opioid users with DDIs compared to those without DDIs ($7841 vs. $5625). The derived medication risk score was higher in CYP2D6 opioid users with interacting drug(s) compared to no DDI (15 vs. 12). Higher costs associated with CYP2D6 opioid use under DDI conditions suggest inadequate CYP2D6 opioid prescribing practices. Efforts to improve chronic opioid use in adults should reduce interacting drug combinations, especially among patients using CYP2D6 activated opioids.

scholarly journals Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

2021 ◽  
Author(s):  
Mina M. Rizk ◽  
Sarah Herzog ◽  
Sanjana Dugad ◽  
Barbara Stanley
Keyword(s):  
Suicide Risk ◽  
Opioid Use ◽  
Opioid Use Disorders ◽  
The Impact

scholarly journals Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans

2020 ◽  
Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman
Keyword(s):  
Multivariate Analysis ◽  
Hospital Admission ◽  
Intervention Group ◽  
Opioid Use Disorder ◽  
Control Group ◽  
Opioid Use ◽  
Motivation To Change ◽  
Heroin Use ◽  
Ed Visits ◽  
The Impact

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (>45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P < 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.

scholarly journals 309. The Impact of Addiction Medicine Consultation on Discharges Against Medical Advice in Patients with Opioid Use Disorder and Staphylococcus Aureus Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S152-S152
Author(s):  
Stephanie Spivack ◽  
Daniel Mueller ◽  
Peter Axelrod ◽  
Joseph D’Orazio
Keyword(s):  
Staphylococcus Aureus ◽  
Patient Population ◽  
Medical Advice ◽  
Index Admission ◽  
Opioid Use ◽  
Urban Hospital ◽  
Addiction Medicine ◽  
Against Medical Advice ◽  
Number Of Patients ◽  
The Impact

Abstract Background People who inject drugs (PWID) are at risk for infectious complications of their injection practices, including Staphylococcus aureus (SA) bacteremia. Prolonged hospitalization is sometimes required; however, rates of discharges against medical advice (AMA) are elevated in this patient population. Inadequate control of pain and opioid withdrawal are commonly cited. Our aim was to assess the effectiveness of addiction medicine consultation for preventing AMA discharges. Methods We performed a retrospective chart review of adult PWID admitted to an urban hospital with SA bacteremia between August 2016 and May 2018. Demographics, HIV and HCV status, and presence or absence of addiction medicine consultation were recorded. We assessed whether discharges were planned or AMA; the number of hospitalizations at 30 days, 90 days, and 1 year from index admission; and death within one year. EpiInfo6 was used for data analysis. Results A total of 360 patients with SA bacteremia were reviewed. Of these, 101 reported intravenous opioid use at admission. Average age was 37 years, and 64% were male. HIV and HCV were present in 13% and 82% of patients, respectively. Addiction medicine was consulted on 29 patients. Of these, 4/29 (13.8%) left AMA, compared to 27/72 (37.5%) of patients without an addiction consult (RR = 0.3678 [95% CI = 0.1412 - 0.9583], p = 0.02). Patients receiving addiction medicine consultation averaged 0.17 readmissions within 30 days of their index admission, compared to 0.39 readmissions in the group without addiction medicine consult (p = 0.27). Readmissions at 90 days and 1 year were also lower but not statistically significant. At 1 year, 6 deaths were observed; 2 who had addiction medicine consultation and 4 who did not. Conclusion Consultation with an addiction medicine specialist significantly reduced the number of patients discharged AMA in a high-risk cohort of PWID presenting with SA bacteremia. Numerically fewer readmissions occurred after consultation, though this difference was not statistically significant. Mortality in both groups was low. There were high rates of HIV and HCV in this patient population, suggesting a particularly vulnerable patient population, which warrants further study. Disclosures All Authors: No reported disclosures

The impact of patient age and procedure type on postoperative opioid use following ambulatory pediatric urologic procedures

2021 ◽  
Author(s):  
Michael F. Basin ◽  
Zoë G. Baker ◽  
Melissa Trabold ◽  
Terry Zhu ◽  
Lorraine I. Kelley-Quon ◽  
...  
Keyword(s):  
Opioid Use ◽  
Patient Age ◽  
Patient Âgé ◽  
The Impact ◽  
Procedure Type

scholarly journals Conceptualizing the effects of the COVID-19 pandemic on people with opioid use disorder: an application of the social ecological model

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ethan Cowan ◽  
Maria R. Khan ◽  
Siri Shastry ◽  
E. Jennifer Edelman
Keyword(s):  
Structural Changes ◽  
Ecological Model ◽  
Disease Incidence ◽  
Opioid Use Disorder ◽  
Social Ecological Model ◽  
Physical And Mental Health ◽  
Opioid Use ◽  
Social Ecological ◽  
The Social ◽  
The Impact

AbstractThe COVID-19 pandemic has resulted in unparalleled societal disruption with wide ranging effects on individual liberties, the economy, and physical and mental health. While no social strata or population has been spared, the pandemic has posed unique and poorly characterized challenges for individuals with opioid use disorder (OUD). Given the pandemic’s broad effects, it is helpful to organize the risks posed to specific populations using theoretical models. These models can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations. Such models are not unidirectional, in that actions of individuals, networks, communities and structural changes can also affect overall disease incidence and prevalence. In this commentary, we describe how the social ecological model (SEM) may be applied to describe the theoretical effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD). This model can provide a necessary framework to systematically guide time-sensitive research and implementation of individual-, community-, and policy-level interventions to mitigate the impact of the COVID-19 pandemic on individuals with OUD.

Conversations About Opioids: Impact of the Opioid Overdose Epidemic on Social Interactions for People Who Live With Chronic Pain

2021 ◽  
pp. 104973232110030
Author(s):  
Lise Dassieu ◽  
Angela Heino ◽  
Élise Develay ◽  
Jean-Luc Kaboré ◽  
M. Gabrielle Pagé ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Media Coverage ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Negative Effects ◽  
Self Advocacy ◽  
Social Lives ◽  
The Social ◽  
The Impact ◽  
Depth Interviews

The objective of this study was to understand the impact of the opioid overdose epidemic on the social lives of people suffering from chronic pain, focusing on interactions within their personal and professional circles. The study was based on 22 in-depth interviews with people living with chronic pain in Canada. Using thematic analysis, we documented three main impacts of the opioid overdose epidemic: (a) increased worries of people in pain and their families regarding the dangers of opioids; (b) prejudices, stigma, and discrimination faced during conversations about opioids; and (c) stigma management attempts, which include self-advocacy and concealment of opioid use. This study represents important knowledge advancement on how people manage stigma and communicate about chronic disease during everyday life interactions. By showing negative effects of the epidemic’s media coverage on the social experiences of people with chronic pain, we underscore needs for destigmatizing approaches in public communication regarding opioids.

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