Early predictors of narcotics-dependent patients in the emergency department
It is not unusual that narcotics-dependent patients fulfill their medical requirements in the emergency department (ED). The behavior of these patients varies, and their manifestations and predictors are still not fully studied. We performed this retrospective study by prospectively collecting data...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-06-01
|
| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X12003002 |
| _version_ | 1830509120774471680 |
|---|---|
| author | Wei-Che Lee Hsing-Lin Lin Liang-Chi Kuo Chao-Wen Chen Yuan-Chia Cheng Tsung-Ying Lin Kwan-Ming Soo Hon-Man Chan |
| author_facet | Wei-Che Lee Hsing-Lin Lin Liang-Chi Kuo Chao-Wen Chen Yuan-Chia Cheng Tsung-Ying Lin Kwan-Ming Soo Hon-Man Chan |
| author_sort | Wei-Che Lee |
| collection | DOAJ |
| description | It is not unusual that narcotics-dependent patients fulfill their medical requirements in the emergency department (ED). The behavior of these patients varies, and their manifestations and predictors are still not fully studied. We performed this retrospective study by prospectively collecting data on patients with suspected drug dependence who were undiagnosed at first and then treated for some kind of reported pain at the ED. Patients who were confirmed to have narcotics dependence were compared with control patients in a ratio of 1:3 matching for age, gender, disease, and clinical diagnoses. From January 2006 to October 2009, 26 of 223 patients treated for pain were found to be drug dependent (12 males and 14 females). The average dose of narcotics used was higher than the control group [3.23 ± 1.14 vs. 1.12 ± 0.36, p < 0.001, confidence interval (CI): 1.648–2.583]. Numbers of patients making unscheduled returns to the ED within 24 hours were significant [24/26 vs. 8/78, p ≤ 0.001, odds ratio (OR) 105.00, 95% CI 20.834–529.175]. In addition, patients showing aggressive attitudes were significant (17/26 vs. 2/78, p < 0.001, OR 71.78, 95% CI 14.206–362.663). In the case group, six of them told the physician that they were allergic to medicines other than the particular one they wanted, and three of the six presented injuries that were reported to be in the same (or repeated) place for unscheduled returns, which were not found in the control group. In this study, some behaviors were commonly observed in the at-risk group. These patients were prone to manifest some types of symptoms and behaviors, such as uncontrolled pain with three doses of analgesics, aggressive attitude, returning to the ED within 24 hours with the complaint of the same severe pain, repeating the same injury, claiming allergy to other analgesics, and asking for certain analgesics. All these behaviors should alert the physician to suspect a drug-seeking problem. |
| first_indexed | 2024-12-22T01:29:52Z |
| format | Article |
| id | doaj.art-09e44bf284d144d5b0e634f82979f6ed |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-22T01:29:52Z |
| publishDate | 2013-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-09e44bf284d144d5b0e634f82979f6ed2022-12-21T18:43:31ZengWileyKaohsiung Journal of Medical Sciences1607-551X2013-06-0129631932410.1016/j.kjms.2012.10.002Early predictors of narcotics-dependent patients in the emergency departmentWei-Che Lee0Hsing-Lin Lin1Liang-Chi Kuo2Chao-Wen Chen3Yuan-Chia Cheng4Tsung-Ying Lin5Kwan-Ming Soo6Hon-Man Chan7Division of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanIt is not unusual that narcotics-dependent patients fulfill their medical requirements in the emergency department (ED). The behavior of these patients varies, and their manifestations and predictors are still not fully studied. We performed this retrospective study by prospectively collecting data on patients with suspected drug dependence who were undiagnosed at first and then treated for some kind of reported pain at the ED. Patients who were confirmed to have narcotics dependence were compared with control patients in a ratio of 1:3 matching for age, gender, disease, and clinical diagnoses. From January 2006 to October 2009, 26 of 223 patients treated for pain were found to be drug dependent (12 males and 14 females). The average dose of narcotics used was higher than the control group [3.23 ± 1.14 vs. 1.12 ± 0.36, p < 0.001, confidence interval (CI): 1.648–2.583]. Numbers of patients making unscheduled returns to the ED within 24 hours were significant [24/26 vs. 8/78, p ≤ 0.001, odds ratio (OR) 105.00, 95% CI 20.834–529.175]. In addition, patients showing aggressive attitudes were significant (17/26 vs. 2/78, p < 0.001, OR 71.78, 95% CI 14.206–362.663). In the case group, six of them told the physician that they were allergic to medicines other than the particular one they wanted, and three of the six presented injuries that were reported to be in the same (or repeated) place for unscheduled returns, which were not found in the control group. In this study, some behaviors were commonly observed in the at-risk group. These patients were prone to manifest some types of symptoms and behaviors, such as uncontrolled pain with three doses of analgesics, aggressive attitude, returning to the ED within 24 hours with the complaint of the same severe pain, repeating the same injury, claiming allergy to other analgesics, and asking for certain analgesics. All these behaviors should alert the physician to suspect a drug-seeking problem.http://www.sciencedirect.com/science/article/pii/S1607551X12003002Drug dependenceEmergency departmentManifestationNarcotics |
| spellingShingle | Wei-Che Lee Hsing-Lin Lin Liang-Chi Kuo Chao-Wen Chen Yuan-Chia Cheng Tsung-Ying Lin Kwan-Ming Soo Hon-Man Chan Early predictors of narcotics-dependent patients in the emergency department Kaohsiung Journal of Medical Sciences Drug dependence Emergency department Manifestation Narcotics |
| title | Early predictors of narcotics-dependent patients in the emergency department |
| title_full | Early predictors of narcotics-dependent patients in the emergency department |
| title_fullStr | Early predictors of narcotics-dependent patients in the emergency department |
| title_full_unstemmed | Early predictors of narcotics-dependent patients in the emergency department |
| title_short | Early predictors of narcotics-dependent patients in the emergency department |
| title_sort | early predictors of narcotics dependent patients in the emergency department |
| topic | Drug dependence Emergency department Manifestation Narcotics |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X12003002 |
| work_keys_str_mv | AT weichelee earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT hsinglinlin earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT liangchikuo earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT chaowenchen earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT yuanchiacheng earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT tsungyinglin earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT kwanmingsoo earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment AT honmanchan earlypredictorsofnarcoticsdependentpatientsintheemergencydepartment |