Howard University College of Pharmacy, Clinical Administrative & Pharmacy Sciences, Washington, DC, USA *Students when research was conducted.
Temple University School of Pharmacy, Philadelphia, PA, USA.
J Pharm Pract. 2024 Feb;37(1):104-109. doi: 10.1177/08971900221128335. Epub 2022 Sep 18.
Sickle Cell Disease (SCD) is known to cause acute severe pain episodes known as vaso-occlusive crisis (VOC) mainly treated with opioid analgesics. Since the opioid epidemic there is an interest in determining the opioid misuse potential in these patients. Therefore, the primary objective of this study is to determine the rates of opioid misuse among patients with SCD by assessing the rate of unexpected drug screening results in a sickle cell disease clinic. This was a retrospective chart review study conducted at the outpatient sickle cell disease clinic. The primary independent variables were the prescribed opioid medications while the primary dependent variable was the collected opioid metabolite. Descriptive statistics, linear regression and multivariate logistic regression analysis were conducted using SPSS version 24. A total of 100 participants were recruited from July 1, 2018, to June 30, 2020 with 71 included in the analysis. The total mean of morphine milligram equivalents (MME) for all participants was 71.1±104.9 with 71% of participants having a daily calculated MME of <90MME. The odds of misusing an opioid were 6.72 times higher (P<.02) if a participant used marijuana compared to a participant who didn't. In addition, the odds of misusing an opioid were 2.47 times higher (P<.04) if the patient was prescribed an opioid daily dose greater than 90 MME as opposed to a daily dose less than 90 MME. Participants who consumed greater than 90 MME's per day and utilized marijuana were more likely to misuse opioids.
镰状细胞病（SCD）会导致急性剧烈疼痛发作，称为血管阻塞性危象（VOC），主要用阿片类镇痛药治疗。由于阿片类药物流行，人们有兴趣确定这些患者的阿片类药物滥用潜力。因此，本研究的主要目的是通过评估镰状细胞病诊所中意外药物筛选结果的发生率来确定 SCD 患者中阿片类药物滥用的发生率。 这是在门诊镰状细胞病诊所进行的回顾性图表审查研究。主要的独立变量是规定的阿片类药物，而主要的因变量是收集的阿片类药物代谢物。使用 SPSS 版本 24 进行描述性统计、线性回归和多变量逻辑回归分析。 2018 年 7 月 1 日至 2020 年 6 月 30 日期间共招募了 100 名参与者，其中 71 名参与者纳入分析。所有参与者的吗啡毫克当量（MME）平均值为 71.1±104.9，71%的参与者每天计算的 MME 低于 90MME。与未使用大麻的参与者相比，使用大麻的参与者滥用阿片类药物的几率高 6.72 倍（P<.02）。此外，如果患者每天服用的阿片类药物剂量大于 90 MME，而不是每天剂量小于 90 MME，则滥用阿片类药物的几率高 2.47 倍（P<.04）。每天消耗大于 90 MME 并使用大麻的参与者更有可能滥用阿片类药物。
