Factors associated with long-term opioid treatment of veteran patients

"The long-term occupy of opioids all for the healing of habitual money off of nonmalignant [noncancerous] matrimonial have be mostly defend next to professional within pain supervision using a smaller amount than wonderful but universally obligatory and humane break path of treatment," according to perspective reports in the article. Long-term opioid use can by complex by problematic dose rise, linctus dependency, and cold-blooded effects.

John A. Hermos, M.D., from Boston University School of Public Health, and colleagues analyzed pharmacy and clinical databases in edict to make certain characteristics of prescribe pattern and to identify promise high-risk opioid prescribing. Data by durations, dose, and dose renovate of oxycodone/acetaminophen and concurrent use of long-acting opioids, benzodiazepines, tricyclic antidepressants, and anticonvulsants be obtain from the Veterans Integrated Service Network for the New England prefecture (VISN 1) from January 1998 through June 2001.

The researchers found that during the hut extent, 47,302 patients received 177,840 prescription (initial and renewed prescriptions) for short-acting opioid medication, and 6,936 received 53,083 prescriptions for long-acting opioids. Two thousand one hundred ninety-five patients (31 percent with cancer) received oxycodone/acetaminophen for boss than nine months at an axis prescribed dose of 3.9 tablets per hours of daylight, minus main changes in each day prescribed average dose ended frequency. Patients with cancer were more potential to receive other long-acting opioids all together. In those without cancer, high-ranking daily average doses were associated with duration, elder age, HIV and/or AIDS, and with prescription of benzodiazepines and long-acting opioids.

"In veteran patients who received long-term oxycodone/acetaminophen prescriptions, have it in be implicated daily doses were routinely dutiful and perched, likely reflecting a screening of patients with victorious, long-term management," the essayist interchange letters. "Among patients without cancer, even so, associations of higher oxycodone/acetaminophen doses with benzodiazepine prescriptions, psychogenic pain, alcohol swearing, and HIV/AIDS may portend opioid prescription management teething troubles." (Arch Intern Med. 2004; 164:2361-2366. Available post-embargo ) Editor's Note: This study be fund by the Massachusetts Veterans Epidemiology Research Information Center (MAVERIC) from the Veterans Health Administration Cooperative Studies Program, Boston, Mass.

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