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Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone.
South Med J. 2017 03; 110(3):217-222.SM

Abstract

OBJECTIVES

Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone.

METHODS

We retrospectively reviewed the medical records of patients identified for drug abuse between January 2012 and December 2015, identifying patients who intravenously abused extended-release oral oxymorphone. Medical charts were reviewed to identify associated sequelae and patients requiring an intensive care unit level of care.

RESULTS

We identified 53 patients who required treatment in an intensive care unit setting as a consequence of intravenously abusing extended-release oral oxymorphone. Twenty-eight patients (52.8%) required endotracheal intubation with mechanical ventilation for either acute hypoxic respiratory failure or protection of airway. Acute kidney injury developed in 48 patients (90.6%); 28.3% of these patients failed to regain renal function and required renal replacement therapy. Bacteremia was diagnosed in 36 patients (67.9%) and 30 patients (56.6%) were diagnosed as having acute infective bacterial endocarditis.

CONCLUSIONS

Our patients demonstrated a great need for critical care resources and severe sequelae related to intravenous drug abuse. Clinicians should be vigilant for the possibility for clinical decompensation when initially evaluating patients reporting intravenous abuse of extended-release oral oxymorphone.

Authors+Show Affiliations

From the Departments of Internal Medicine and Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.From the Departments of Internal Medicine and Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.From the Departments of Internal Medicine and Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.From the Departments of Internal Medicine and Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28257549

Citation

Wilson, Matthew W., et al. "Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone." Southern Medical Journal, vol. 110, no. 3, 2017, pp. 217-222.
Wilson MW, Bonnecaze AK, Dharod A, et al. Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone. South Med J. 2017;110(3):217-222.
Wilson, M. W., Bonnecaze, A. K., Dharod, A., & Miller, P. J. (2017). Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone. Southern Medical Journal, 110(3), 217-222. https://doi.org/10.14423/SMJ.0000000000000624
Wilson MW, et al. Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone. South Med J. 2017;110(3):217-222. PubMed PMID: 28257549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone. AU - Wilson,Matthew W, AU - Bonnecaze,Alex K, AU - Dharod,Ajay, AU - Miller,Peter J, PY - 2017/3/4/entrez PY - 2017/3/4/pubmed PY - 2017/5/26/medline SP - 217 EP - 222 JF - Southern medical journal JO - South. Med. J. VL - 110 IS - 3 N2 - OBJECTIVES: Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone. METHODS: We retrospectively reviewed the medical records of patients identified for drug abuse between January 2012 and December 2015, identifying patients who intravenously abused extended-release oral oxymorphone. Medical charts were reviewed to identify associated sequelae and patients requiring an intensive care unit level of care. RESULTS: We identified 53 patients who required treatment in an intensive care unit setting as a consequence of intravenously abusing extended-release oral oxymorphone. Twenty-eight patients (52.8%) required endotracheal intubation with mechanical ventilation for either acute hypoxic respiratory failure or protection of airway. Acute kidney injury developed in 48 patients (90.6%); 28.3% of these patients failed to regain renal function and required renal replacement therapy. Bacteremia was diagnosed in 36 patients (67.9%) and 30 patients (56.6%) were diagnosed as having acute infective bacterial endocarditis. CONCLUSIONS: Our patients demonstrated a great need for critical care resources and severe sequelae related to intravenous drug abuse. Clinicians should be vigilant for the possibility for clinical decompensation when initially evaluating patients reporting intravenous abuse of extended-release oral oxymorphone. SN - 1541-8243 UR - https://www.unboundmedicine.com/medline/citation/28257549/Analysis_of_Intensive_Care_Unit_Admission_and_Sequelae_in_Patients_Intravenously_Abusing_Extended_Release_Oral_Oxymorphone_ L2 - http://dx.doi.org/10.14423/SMJ.0000000000000624 DB - PRIME DP - Unbound Medicine ER -