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Evaluation of Opioid Use in Acute Pancreatitis in Absence of Chronic Pancreatitis: Absence of Opioid Dependence an Important Feature
- Source :
- The American Journal of Medicine. 133:1209-1218
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Chronic opioid use and dependence is common in patients with chronic pancreatitis. Patients with acute pancreatitis are frequently treated with opioids, but their risk for ongoing use is not well known. The aim of our study is to characterize opioid use in patients after an episode of acute pancreatitis and to assess persistent, chronic, and daily opioid use in such patients in the absence of chronic pancreatitis. Methods This is a single-center review of prospectively enrolled patients with acute pancreatitis. Using the Massachusetts Prescription Awareness Tool, we recorded all opioid prescriptions (ie, frequency, duration, and amount) for patients from December 2016 to September 2019, after index hospitalization for acute pancreatitis. Patients with chronic pancreatitis were excluded. We used univariate and multivariate analysis to determine predictors of opioid use at discharge and subsequent follow-up over 18 months. Results Of 235 enrolled patients who were opioid-naive, 123 patients (52.3%) received opioids at discharge after index hospitalization. In follow-up over 18 months, 40 patients (17.0%) received additional opioid prescriptions. These patients had more severe disease, longer length of stay, and higher pain score at discharge. Patients with prior history of acute pancreatitis, local complications, and higher pain scores were twice as likely to subsequently be prescribed opioids. Persistent opioid use was seen only in recurrent acute pancreatitis. There was no daily or chronic opioid use. Conclusions In the absence of chronic pancreatitis, there was no daily or chronic use of opioids in patients with acute pancreatitis. Persistent use was only seen in patients with recurrent acute pancreatitis. These patients are at increased risk of chronic opioid use and dependence.
- Subjects :
- Adult
Male
medicine.medical_specialty
Multivariate analysis
Severe disease
030204 cardiovascular system & hematology
Severity of Illness Index
Endosonography
03 medical and health sciences
0302 clinical medicine
Recurrence
Pancreatitis, Chronic
Internal medicine
medicine
Humans
Cholecystectomy
Prospective Studies
030212 general & internal medicine
Medical prescription
Aged
Pain Measurement
Cholangiopancreatography, Endoscopic Retrograde
Pain score
business.industry
Opioid use
General Medicine
Length of Stay
Middle Aged
Opioid-Related Disorders
medicine.disease
Analgesics, Opioid
Pancreatitis
Opioid
Drainage
Acute pancreatitis
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 00029343
- Volume :
- 133
- Database :
- OpenAIRE
- Journal :
- The American Journal of Medicine
- Accession number :
- edsair.doi.dedup.....a4f0da6874ae989d41f510fdebdce680