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The American journal of emergency medicine

Substance use disorders : , Substance use disorders : , کتابخانه مرکزی دانشگاه علوم پزشکی تهران

Substance use disorders

Objective To determine the risk of prolonged opioid use in patients receiving tramadol compared with other short acting opioids. Design Observational study of administrative claims data. Setting United States commercial and Medicare Advantage insurance claims (OptumLabs Data Warehouse) January 1, 2009 through June 30, 2018. Participants Opioid-naive patients undergoing elective surgery. Main outcome measure Risk of persistent opioid use after discharge for patients treated with tramadol alone compared with other short acting opioids, using three commonly used definitions of prolonged opioid use from the literature: additional opioid use (defined as at least one opioid fill 90-180 days after surgery); persistent opioid use (any span of opioid use starting in the 180 days after surgery and lasting ≥90 days); and CONSORT definition (an opioid use episode starting in the 180 days after surgery that spans ≥90 days and includes either ≥10 opioid fills or ≥120 days’ supply of opioids). Results Of 444 764 patients who met the inclusion criteria, 357 884 filled a discharge prescription for one or more opioids associated with one of 20 included operations. The most commonly prescribed post-surgery opioid was hydrocodone (53.0% of those filling a single opioid), followed by short acting oxycodone (37.5%) and tramadol (4.0%). The unadjusted risk of prolonged opioid use after surgery was 7.1% (n=31 431) with additional opioid use, 1.0% (n=4457) with persistent opioid use, and 0.5% (n=2027) meeting the CONSORT definition. Receipt of tramadol alone was associated with a 6% increase in the risk of additional opioid use relative to people receiving other short acting opioids (incidence rate ratio 95% confidence interval 1.00 to 1.13; risk difference 0.5 percentage points; P=0.049), 47% increase in the adjusted risk of persistent opioid use (1.25 to 1.69; 0.5 percentage points; P Conclusions People receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.

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Chronic use of tramadol after acute pain episode: Cohort study

Comparative pharmacology and toxicology of tramadol and tapentadol.

First report on the pharmacokinetics of tramadol and O-desmethyltramadol in exhaled breath compared to plasma and oral fluid after a single oral dose.

Background: Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has...

Adolescent tramadol use and abuse in Egypt.

Background Tramadol use is an overwhelming problem in Egypt with tremendous medical and social consequences especially among youth. Use liability among Egyptian university students is underevaluated. This study aimed to estimate the prevalence and associated correlates of tramadol use among students from Zagazig University, Egypt. Methods A cross-sectional study included a total of 1135 undergraduate students, from 10 colleges in Zagazig University. Participants were randomly selected and assessed for tramadol use using The Drug Use Disorders Identification Test (DUDIT) and The Drug Use Disorders Identification Test-Extended (DUDIT-E). Results The prevalence of tramadol use was 12.3% among university students, with higher prevalence in male (20.2%) than female students (2.4%). The average age at onset of tramadol use was 17.6 ± 2.1. Only 15% of the students with substance use were using tramadol alone whereas the rest (85%) were using at least 1 drug plus tramadol. One-fifth of these students started with tramadol as their first drug. Smoking, cannabis, and alcohol use predict tramadol use. About 60% of students who use tramadol had drug-related problems and 30% had dependence. Treatment readiness for tramadol use is negatively correlated with smoking and its duration. Conclusions Tramadol use was common among university students, with higher prevalence among males. There is a considerable relationship between tramadol use, smoking, and use of other substances. Further population-based longitudinal studies need to investigate the causal relationship between tramadol use, smoking, and use of other substances.

Opioid Use Disorders Attributed to Tramadol Among Egyptian University Students.

Background and objective Cognitive impairment is one of the consequences of substance abuse. Tramadol abuse is a public health problem in Egypt. The objective of this study was to estimate the prevalence and correlates of cognitive impairment among tramadol-abuse patients and control subjects. Methods This study included 100 patients with tramadol abuse and 100 control subjects (matched for age, sex, and education) who were recruited from Zagazig University Hospital, Egypt. Patients were divided into 2 groups: patients who used tramadol only (tramadol-alone group) and patients who used tramadol and other substances (polysubstance group). The participants were interviewed using Montreal Cognitive Assessment test and had urine screening for drugs. Results Twenty-four percent of the cases used tramadol alone, whereas the remaining used tramadol and other substances, mainly cannabis (66%) and benzodiazepines (27%). Tramadol-abuse patients were about 3 times more likely to have cognitive impairment than control subjects (81% vs 28%). Tramadol-alone patients were more than 2 times more likely to have cognitive impairment than control subjects (67% vs 28%). Cognitive impairment was significantly associated with polysubstance abuse. There was no association between cognitive impairment and sociodemographic or clinical factors. Conclusions Cognitive impairment occurs commonly among tramadol-abuse patients. Memory impairment is the most common cognitive domain to be affected. There is a significant association between cognitive impairment and polysubstance abuse.

Cognitive Impairment and Tramadol Dependence.

Aim of the study: Healthcare workers (HCWs) are more prone to extraordinary fears of COVID – 19 virus infection. This study aimed to explore the frequency and predictors of health anxiety to COVID-19 virus infection among HCWs and identify its relationship to their quality of life (QOL). Material and methods: A cross-sectional study was conducted among a sample of HCWs in hospitals of Sharkia Province, Egypt from June 30 to July 16, 2020. A total of 218 HCWs were interviewed using the short health anxiety inventory (SHAI), Symptom Check List-90-Revised (SCL-90-R), and The World Health Organization Quality of Life – BREF (WHOQOL-BREF). Results: The frequency of health anxiety to COVID-19 virus among HCWs was 28%. Symptoms of depression, hostility, phobia and somatization, and history of chronic medical illnesses showed greater odds of health anxiety to COVID-19 virus (OR: 6.7, 9.1, 7.3, 7.7, and 12.6, respectively). Being physicians and the increased number of sleeping hours were less likely associated with health anxiety to COVID-19 virus (OR: 0.1 and 0.5, respectively). Health anxiety to COVID-19 virus was inversely correlated with all domains of QOL among HCWs. Conclusions: Health anxiety to Covid-19 virus infection is common among HCWs, and it negatively affects their QOL. © 2021 Polish Psychiatric Association. All rights reserved.

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Health anxiety to COVID-19 virus infection and its relationship to quality of life in a sample of health care workers in Egypt: A cross-sectional study

Background: Substance use is a public health problem among adolescents and young adults in Egypt. Objective: The objective of this study was to estimate the prevalence and correlates of substance use among Egyptian university students. Methods: This study randomly included 1176 (57.4% were male individuals) university students, with almost two thirds from practical course majors, with the remaining students from theoretical course majors. They answered a questionnaire of sociodemographic and clinical characteristics, which included the drug use disorders identification test, which was used to estimate student drug-related problems and dependence. Results: Lifetime substance use among students is 22.5%, with 156 (58.9%) demonstrating a polysubstance need, 221 (83.4%) using cannabis, 145 (54.7%) using tramadol, and 106 (40%) using alcohol. There is a significant association between substance use and older age, male sex, those in theoretical education, those living in an urban residence, and those who smoke cigarettes. In the group that used substances, currently, 114 (43%) experience drug-related problems and 43 (16.2%) experience dependence. Students with both issues are more likely to use alcohol, tramadol, or polysubstance than those without them; students with drug dependence are more likely to come from theoretical colleges, to smoke cigarettes, or to use substances at a younger age than those with drug-related problems. Conclusions: One in 5 university students used substances at least once in their lives. The most common included cannabis, tramadol, and alcohol, respectively. The risk factors for substance use were older age, male sex, urban residence, theoretical education, and cigarette smoking.

Hayam El-Gohari

Papers

Adolescent tramadol use and abuse in Egypt.

Opioid Use Disorders Attributed to Tramadol Among Egyptian University Students.

Cognitive Impairment and Tramadol Dependence.

Health anxiety to COVID-19 virus infection and its relationship to quality of life in a sample of health care workers in Egypt: A cross-sectional study

Addressing prevalence and correlates among a sample of Egyptian university students who suffer from substance use disorders