SRF024: Examining Injury Characteristics in Predicting Opioid Misuse and Addiction Among Victims of Traumatic Injury
Ola Shana; Alyssa Tilhou, MD, PhD; Amelia Baltes, MPH; Randall Brown, MD
Context: More than 2 million Americans misuse opioids each year. Any exposure to opioids can lead to misuse, with victims of traumatic injury at greater than average risk. Studies suggest that features such as injury severity and injury location may be predictors for opioid misuse. This work is pertinent to primary care, as many injured patients receive long-term follow up care and pain management through primary care providers . Objective: To examine the relationship between key injury characteristics, severity and location, and risk of opioid misuse and opioid use disorder (OUD). Human Subjects Review: Approved by the University of Wisconsin’s (UW) Health Sciences Institutional Review Board. Design: Secondary data analysis of data from the Screening in Trauma for Opioid Misuse Prevention (STOMP) study, a prospective cohort study, which aimed to evaluate patient and injury-related variables associated with the development of opioid misuse and OUD. Setting: 295 participants recruited from the UW Hospital Trauma Inpatient Service with surveys collected at 4, 12, and 24 weeks. Inclusion criteria included ages 18–75 years, inpatient victim of traumatic injury, need for post-discharge outpatient opioid analgesia, English speaking, and post-discharge ability to manage their own medications. Participants unable to meet these criteria, as well as participants with an active OUD, enrollment in a recovery program for another substance use disorder, or with a concurrent cancer diagnosis were excluded. Outcomes: The development of opioid misuse or OUD during 24 weeks follow up, as measured by the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Results: 5.86% and 3.35% of participants developed opioid misuse and OUD, respectively. In bivariate, logistic regression analyses, injury severity was not significantly associated with opioid misuse or OUD. When analyzing by body region, spinal injuries were significantly associated with opioid misuse and nearly significant with OUD. Next, a multivariate logistic regression model will be used to further assess these variables. Conclusions: Injury severity, as assessed by ISS and NISS, may not play a large role in the development of opioid misuse. Spinal injuries may increase risk for opioid misuse and addiction. Further exploration is needed. These findings can provide clinicians with valuable insight to help minimize future risk of substance use disorders among patients with traumatic injury.