Dependence to legally prescribed opioid analgesics in a university hospital in Medellin-Colombia : an observational study

ABSTRACT: Background In some countries the misuse and diversion of prescribed opioid analgesic is increasing considerably, but there is no official data regarding the situation in Colombia. The aim of this study was to identify all dependent to opioid analgesics legally prescribed patients that were...

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Autores:
García Orjuela, María Gabriela
Alarcon Franco, Lineth
Sanchez Fernandez, Juan Carlos
Agudelo, Yuli
Zuluaga Salazar, Andrés Felipe
Tipo de recurso:
Article of investigation
Fecha de publicación:
2016
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/25820
Acceso en línea:
http://hdl.handle.net/10495/25820
Palabra clave:
Analgésicos
Analgesics
Tramadol
Dolor
Pain
Trastornos Relacionados con Opioides
Opioid-Related Disorders
Rights
openAccess
License
http://creativecommons.org/licenses/by/2.5/co/
Description
Summary:ABSTRACT: Background In some countries the misuse and diversion of prescribed opioid analgesic is increasing considerably, but there is no official data regarding the situation in Colombia. The aim of this study was to identify all dependent to opioid analgesics legally prescribed patients that were treated in a University Hospital in Medellin, Colombia during 4 years and to characterize this population. Methods Observational study in a University Hospital in Medellin, Colombia, searching for patients with ICD-10 codes related with opioid related disorders, adverse events or pain and treated between January 2011 and December 2014. Results Sixty patients with opioid dependence according to DSM-IV criteria were found from 3332 clinical charts reviewed. The median age was 43 years. Although all patients met the DSM-IV criteria, 33 % of patients were wrongly diagnosed by other ICD-10 codes. Almost all patient (88 %) initiated opioids after medical prescription although the adherence to pain scale was low (25 %). The median time of consumption was 48 months. Tramadol was the opioid more frequently used by patients, followed by morphine and oxycodone. A statistically significant higher consumption of other psychotropic substances was observed in male than female (P = 0.005 by Fisher’s test). After be diagnosed, 55 % of patients gone a methadone-based replacement therapy. Conclusion Legally prescribed opioid dependence was belatedly diagnosed in 60 patients in a University hospital, after prolonged use of drugs to treat chronic pain and with low adherence to pain scale or guidelines. This is the first report in Colombia.