Prescription size predicts persistent opioid use after cardiothoracic surgery

Prescription size is associated with increased new persistent opioid use among patients after cardiothoracic surgery, according to a study published online Aug. 22 in the Annals of Thoracic Surgery.

Alexander A. Brescia, M.D., from the University of Michigan in Ann Arbor, and colleagues identified opioid-naive Medicare patients undergoing cardiothoracic surgery between 2009 and 2015. They selected 24,549 patients who filled an opioid prescription between 30 days before surgery and 14 days after discharge and with continuous Medicare enrollment. The correlation for prescription size with new persistent opioid use was examined.

The researchers found that new persistent use was 12.8 percent overall and decreased annually, from 17 to 7.1 percent from 2009 to 2015. Associations with new persistent use were seen for prescription size, preoperative prescription fills, black race, gastrointestinal complications, disability status, open lung resection, dual eligibility (Medicare and Medicaid), drug and substance abuse, female sex, tobacco use, high comorbidity, pain disorders, longer hospital stay, and younger age. Among patients prescribed more than 450 oral morphine equivalents, adjusted new persistent use was 19.6 percent compared with 10.4 percent among those prescribed 200 oral morphine equivalents or less.

Full story at Medical Xpress

Before Teen Is Prescribed Opioids, Look at Family’s Drug Use

Teens and young adults haven’t been spared from the opioid addiction crisis sweeping through America.

And new research shows that when a teen is prescribed an opioid painkiller after minor surgery, his or her odds for long-term abuse nearly doubles if someone living at home already has an opioid use problem.

The study of more than 300,000 people averaging 17 years of age found that after being prescribed an opioid painkiller for post-op pain, 4.1 percent went on to use the drug long-term if another person living in the family home had already been using opioids long-term.

That’s compared to just 2.4 percent of young patients without such histories, said researchers led by Dr. Jennifer Waljee, from the University of Michigan Medical School.

Full story at HealthDay

Five million American adults misusing prescription stimulants

Scientists at the U.S. Department of Health and Human Services have completed the first comprehensive analysis of the prevalence of prescription stimulant use, misuse, use disorders, and motivations for misuse in the U.S. adult population. Looking at annual averages, approximately 6.6% (or 16 million) of U.S. adults used prescription stimulants in the preceding year; 4.5% (or 11 million) used prescription stimulants appropriately (without misuse); 2.1% (or 5 million) misused prescription stimulants at least once; and 0.2% (or 0.4 million) had prescription stimulant use disorders. The article analyzed data from the 2015 and 2016 National Surveys on Drug Use and Health conducted by the Substance Abuse and Mental Health Administration (SAMHSA).

Full story at drugabuse.org

Hospitals Retraining Staff to Minimize Opioid Prescriptions


A growing number of hospitals across the country are rewriting protocols and retraining staff in an effort to minimize opioid prescriptions, PBS NewsHour reports. The changes are most pronounced in emergency departments.

At the University of Kentucky Albert B. Chandler Hospital, emergency room doctors used to give opioid painkillers right away. Dr. Phillip Chang, the hospital’s chief medical officer, says now doctors, pharmacists and nurses use non-opioid pain relievers like Advil or Tylenol first. They try multiple regimens before considering opioids.

Full story of hospital retraining to minimize opioid prescriptions at drugfree.org

Routine drug screening should be part of primary care settings, study recommends

The misuse of both prescription and illicit drugs is so prevalent in Tijuana and East Los Angeles that community clinics in those areas should routinely, though discreetly, screen for it, according to new UCLA research.

The study, published in the peer-reviewed journal Substance Use and Misuse, found that 19.4 percent of people answering a computerized self-administered survey in East Los Angeles community clinics admitted to moderate-to-high drug use. In Tijuana it was 5.7 percent. Rates of drug use among the participants in the study were much higher than what has been found in household surveys in the two countries.

The researchers also found that Los Angeles patients born in Mexico were twice as likely, and Los Angeles patients born in the United States were six times more likely, of being moderate-to-high drug users compared with Tijuana patients born in Mexico. The findings of high rates of drug use ran counter to assumptions, said Dr. Lillian Gelberg, the study’s lead investigator and a professor of family medicine at the David Geffen School of Medicine at UCLA.

Full story of drug screening and primary care settings at Science Daily