- Patients who tested positive for drugs after a vehicle trauma consumed 40% more opioids for acute pain than those who tested negative.
- One-third of accident patients tested positive for drugs or alcohol.
Why this matters
- Patients who test positive for substances may require a special acute pain management strategy.
- Retrospective multi-institutional study evaluated 176 patients with vehicular trauma who were admitted to 4 level 1 trauma centers over the course of 4 months.
- Effect of positive urine drug screen (UDS) and positive blood alcohol content (BAC; ≥80 mg/dL) on pain management with opioid analgesics over the hospital stay was examined.
- Funding: Swedish Medical Center; St. Anthony Hospital.
- A positive drug/alcohol finding was reported in 33.5% of patients, including 12.5% and 26% with a positive UDS and BAC, respectively.
- Patients with positive vs negative UDS had significantly greater opioid consumption (34.7 vs 24.7 mg morphine equivalents; P=.04), corresponding to a 1.4-fold increased consumption of opioids for acute pain management.
- After adjustment, average daily pain scores were similar irrespective of UDS and BAC findings (P=.76).
- Study only 60% powered to detect the observed differences.
- Patients may be misclassified as substance users and nonsubstance users.
Coauthored with Antara Ghosh, PhD