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Related Concept Videos

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Related Experiment Video

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Population and Single-Cell Analysis of Antibiotic Persistence in Escherichia coli
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Persistent Opioid Use Among Patients with Urolithiasis: A Population based Study.

Gregory W Hosier1, Thomas McGregor1, Darren Beiko1

  • 1Department of Urology, Queen's University, Kingston, Canada.

European Urology Focus
|September 14, 2019
PubMed
Summary

Nine percent of opioid-naïve patients with urolithiasis (kidney stones) had persistent opioid use 3-6 months after initial presentation. Higher initial opioid doses and specific stone interventions increased this risk.

Keywords:
OpioidPainSurgeryUrolithiasis

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Area of Science:

  • Urology
  • Pain Management
  • Public Health

Background:

  • Urolithiasis frequently causes acute pain, leading to opioid prescriptions.
  • The long-term risk of opioid dependence after urolithiasis is not well understood.

Purpose of the Study:

  • To determine the rate of opioid prescription for urolithiasis.
  • To identify risk factors for persistent opioid use in these patients.

Main Methods:

  • Population-based study of Ontario urolithiasis patients (2013-2017).
  • Defined persistent opioid use as dispensing opioids 91-180 days post-presentation.
  • Used logistic regression and Cox models to analyze risk factors.

Main Results:

  • 66% of opioid-naïve patients received initial opioid prescriptions.
  • 9% of these patients exhibited persistent opioid use.
  • Increased healthcare visits, stone interventions, higher initial opioid dosage (e.g., >300 OMEs), and specific procedures (shockwave lithotripsy vs. ureteroscopy) were associated with higher persistent use risk.

Conclusions:

  • Most urolithiasis patients receive opioid prescriptions.
  • A significant minority (9%) of previously opioid-naïve patients develop persistent opioid use.
  • Opioid dose and surgical intervention type are key risk factors for prolonged opioid use.