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  4. Assessment of high-risk opioid use metrics among individuals with spinal cord injury: A brief report

Assessment of high-risk opioid use metrics among individuals with spinal cord injury: A brief report

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2084931 · Published: July 1, 2023

Spinal Cord InjuryPharmacologyPain Management

Simple Explanation

This study looks at how often people with spinal cord injuries (SCI) in South Carolina are prescribed opioids in ways that could be risky, like long-term use or high doses. The researchers used data from a registry of people with SCI and a prescription drug monitoring program to track opioid prescriptions. The study found that a notable percentage of individuals with SCI are receiving potentially high-risk opioid prescriptions, highlighting the need for careful prescribing and monitoring.

Study Duration
4 Years
Participants
503 individuals with chronic SCI
Evidence Level
Cohort Study

Key Findings

  • 1
    Over half (53%) of the individuals filled an opioid prescription in years 2–3 after injury.
  • 2
    Of those with any opioid prescriptions, nearly half (47%) had a prescription filled for chronic opioids.
  • 3
    In any given quarter, 39%–49% of those individuals prescribed chronic opioids had a daily MME ≥50 and approximately 25% (range 23%–31%) of the individuals had daily MME ≥90.

Research Summary

This study assessed high-risk opioid prescription metrics among individuals with chronic SCI, including chronic use, high-dose therapy, and concurrent BSH use. The findings indicate a concerning number of individuals with SCI are receiving high-risk opioid prescriptions, including chronic, high-dose, and concurrent use with benzodiazepines, sedatives, or hypnotics. The authors suggest a need for more cautious opioid prescribing and monitoring of high-risk use in adults with chronic SCI, as well as further research to understand the factors contributing to high-risk opioid use in this population.

Practical Implications

Informed Prescribing

Encourages cautious opioid prescribing practices for individuals with SCI.

Targeted Interventions

Highlights the need for tailored interventions to reduce high-risk opioid use and provide alternative therapies.

Further Research

Calls for continued study to understand the prevalence, patterns, predictors, and consequences of high-risk opioid use.

Study Limitations

  • 1
    The current study is limited by the datasets and study timeframe, as detailed in the previous publication.
  • 2
    due to dataset limitations, we did not include the full set of metrics as outlined by the Bree Collaborative.
  • 3
    metrics 3 and 4 were calculated using the number of individuals prescribed an opioid as the denominator, rather than the size of the total population.

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