Abstract
BackgroundIn 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.MethodsObservational 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.ResultsSixty 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.ConclusionLegally 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.
Highlights
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 patients with opioid analgesic dependence that were treated in a University Hospital in Medellin, Colombia during 4 years and to characterize this population
Study Retrospective observational study reviewing the clinical chart of all patients treated for dependency to legally prescribed opioids in the University Hospital (Hospital Universitario San Vicente Fundacion) in Medellin, Colombia between January 2011 and December 2014
Summary
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 effectiveness of opioid therapy to improve chronic pain is questionable [2], the successful pain relief may require high doses and longtime usage of opioids, increasing the risk of abuse and dependence disorders induced by these drugs [3]. The medical dilemma is simple, physicians need opioid drugs as treatment but there is an unequivocal risk of abuse and dependence that should be considered and minimized. The abuse and diversion of prescribed opioid analgesic is growing since two decades ago [5]. In Australia and New Zealand the opioid abuse and dependence is at least three fold more common than similar disorders induced by heroin [1, 4, 6]
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