Affiliation:
1. Department of Anesthesiology and Perioperative Medicine Maine Medical Center Portland ME USA
2. Spectrum Healthcare Partners South Portland ME USA
3. Department of Pharmacy Maine Medical Center Portland ME USA
4. Department of Critical Care Services Maine Medical Center Portland ME USA
5. Tufts University School of Medicine Boston MA USA
6. Department of Anesthesiology Montefiore Medical Center and Albert Einstein College of Medicine Bronx NY USA
7. MaineHealth Institute for Research Scarborough ME USA
Abstract
AbstractThe number of patients maintained on buprenorphine is steadily increasing. To date, no study has reported buprenorphine management practices for these patients during critical illness, nor its relationship with supplemental full‐agonist opioid administration during their hospital stay. In this single‐center retrospective study, we have explored the incidence of buprenorphine continuation during critical illness among patients receiving buprenorphine for the treatment of opioid use disorder. Additionally, we investigated the relationship between nonbuprenorphine opioid exposure and buprenorphine administration during the intensive care unit (ICU) and post‐ICU phases of care. Our study included adults maintained on buprenorphine for opioid use disorder admitted to the ICU between December 1, 2014, and May 31, 2019. Nonbuprenorphine, full agonist opioid doses were converted to fentanyl equivalents (FEs). Fifty‐one (44%) patients received buprenorphine during the ICU phase of care, with an average dose of 8 (8–12) mg/day. During the post‐ICU phase of care, 68 (62%) received buprenorphine, with an average dose of 10 (7–14) mg/day. Lack of mechanical ventilation and acetaminophen use were also associated with buprenorphine use. Full agonist opioid use was more frequent on days when buprenorphine was not given (odds ratio [OR], 6.2 [95% CI, 2.3–16.4]; P < .001). Additionally, the average cumulative dose of opioids given on nonbuprenorphine administration days was significantly higher both in the ICU (OR, 1803 [95% CI, 1271–2553] vs OR, 327 [95% CI, 152–708] FEs/day; P < 0.001) and after ICU discharge (OR, 1476 [95% CI, 962–2265] vs OR, 238 [95% CI, 150‐377] FEs/day; P < .001). Given these findings, buprenorphine continuation during critical illness should be considered, as it is associated with significantly decreased full agonist opioid use.
Subject
Pharmacology (medical),Pharmacology
Reference19 articles.
1. National Institute on Drug Abuse.Effective treatments for opioid addiction.2016.https://nida.nih.gov/publications/effective‐treatments‐opioid‐addiction. Accessed February 6 2023.
2. Treatment of Opioid-Use Disorders
3. Substance Abuse and Mental Health Services Administration.National survey of substance abuse treatment services: 2020. Data on substance abuse treatment facilities.2021.https://www.samhsa.gov/data/report/national‐survey‐substance‐abuse‐treatment‐services‐n‐ssats‐2020‐data‐substance‐abuse. Accessed February 6 2023.
4. Maine Health Data Organization.Prescription drug costs and utilization in maine at retail and mail order pharmacies.2019.https://mhdo.maine.gov/tableau/prescriptionReports.cshtml. Accessed February 6 2023.
5. A national survey of approaches to manage the ICU patient with opioid use disorder
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