Opioid prescription and opioid disorders in burns: A large database analysis from 1990 to 2019.


Journal

Burns : journal of the International Society for Burn Injuries
ISSN: 1879-1409
Titre abrégé: Burns
Pays: Netherlands
ID NLM: 8913178

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 22 11 2022
revised: 28 06 2023
accepted: 20 09 2023
medline: 4 12 2023
pubmed: 24 10 2023
entrez: 23 10 2023
Statut: ppublish

Résumé

Opioids remain crucial in the management of burn pain. A comprehensive analysis of opioid use in burns and their complications has not been investigated. Data were collected from TriNetX, a large multicenter database with de-identified patient information. The population included patients prescribed opioids on or following burn injury from January 1st, 1990, to December 31st, 2019. Opioid prescription use was analyzed after cohort stratification by decades: 1990-1999, 2000-2009, and 2010-2019. Outcomes for opioid-related disorders, opioid dependence, opioid abuse, intentional self-harm, and mental and behavioral disorders from psychoactive substance use were investigated. Hydrocodone was the most frequently prescribed opioid in 1990-1999 and 2000-2009, with oxycodone taking the lead in 2010-2019 (p < 0.0001). During 1990-1999, patients had a decreased risk of recorded opioid-related disorders (RR=0.52), opioid dependence (RR=0.46), opioid abuse (RR=0.55), mental and behavioral disorders (RR=0.88), and intentional self-harm (RR=0.37) when compared to 2000-2009. A comparison of the 2000-2009-2010-2019 cohorts showed an increased risk of recorded opioid-related disorders (RR= 1.91), opioid dependence (RR=1.56), opioid abuse (RR=1.67), mental and behavioral disorders (RR =1.73), and intentional self-harm (RR=2.02). The risk of opioid-related disorders has nearly doubled since the year 2000 warranting precautions when prescribing pain medications to burn patients.

Sections du résumé

BACKGROUND BACKGROUND
Opioids remain crucial in the management of burn pain. A comprehensive analysis of opioid use in burns and their complications has not been investigated.
METHODS METHODS
Data were collected from TriNetX, a large multicenter database with de-identified patient information. The population included patients prescribed opioids on or following burn injury from January 1st, 1990, to December 31st, 2019. Opioid prescription use was analyzed after cohort stratification by decades: 1990-1999, 2000-2009, and 2010-2019. Outcomes for opioid-related disorders, opioid dependence, opioid abuse, intentional self-harm, and mental and behavioral disorders from psychoactive substance use were investigated.
RESULTS RESULTS
Hydrocodone was the most frequently prescribed opioid in 1990-1999 and 2000-2009, with oxycodone taking the lead in 2010-2019 (p < 0.0001). During 1990-1999, patients had a decreased risk of recorded opioid-related disorders (RR=0.52), opioid dependence (RR=0.46), opioid abuse (RR=0.55), mental and behavioral disorders (RR=0.88), and intentional self-harm (RR=0.37) when compared to 2000-2009. A comparison of the 2000-2009-2010-2019 cohorts showed an increased risk of recorded opioid-related disorders (RR= 1.91), opioid dependence (RR=1.56), opioid abuse (RR=1.67), mental and behavioral disorders (RR =1.73), and intentional self-harm (RR=2.02).
CONCLUSIONS CONCLUSIONS
The risk of opioid-related disorders has nearly doubled since the year 2000 warranting precautions when prescribing pain medications to burn patients.

Identifiants

pubmed: 37872016
pii: S0305-4179(23)00186-9
doi: 10.1016/j.burns.2023.09.013
pii:
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1845-1853

Informations de copyright

Copyright © 2023 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest The authors declare no conflict of interest.

Auteurs

Elvia Villarreal (E)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Steven E Wolf (SE)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.

George Golovko (G)

Department of Pharmacology, University of Texas Medical Branch, Galveston, TX, USA.

Shelby Bagby (S)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Kendall Wermine (K)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Sunny Gotewal (S)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Ann Obi (A)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Kassandra Corona (K)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Lyndon Huang (L)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Phillip Keys (P)

School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Juquan Song (J)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.

Amina El Ayadi (A)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: amelayad@utmb.edu.

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Classifications MeSH