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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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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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  11. Impact Of Reported Nsaid "allergies" On Opioid Use Disorder In Back Pain

Impact of reported NSAID "allergies" on opioid use disorder in back pain

Lily Li1, Yuchiao Chang2, Shuang Song3

  • 1Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.

The Journal of Allergy and Clinical Immunology
|September 11, 2020

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View abstract on PubMed

Summary
This summary is machine-generated.

Patients with chronic back pain reporting nonsteroidal anti-inflammatory drug (NSAID) allergies have a higher risk of developing opioid use disorder (OUD). Allergy evaluation is crucial for managing pain and reducing OUD risk.

Area of Science:

  • Pain Management
  • Pharmacovigilance
  • Public Health

Background:

  • Identifying patients at high risk for opioid use disorder (OUD) is critical.
  • Reported nonsteroidal anti-inflammatory drug (NSAID) allergies may increase the likelihood of using stronger pain medications and developing OUD.

Purpose of the Study:

  • To investigate the clinical impact of reported NSAID allergy on OUD risk in patients with chronic back pain.

Main Methods:

  • Retrospective study of adults with chronic back pain (2013-2018).
  • Propensity score matching and logistic regression used to assess the impact of NSAID adverse drug reactions (ADRs) on OUD risk.
  • OUD and back pain identified via administrative data algorithms.

Main Results:

Keywords:
Aspirinadverse drug reactionanalgesicsdrug allergy

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  • 7.7% of patients with chronic back pain reported NSAID ADRs.
  • Patients with NSAID ADRs had 1.34 times higher odds of developing OUD.
  • NSAID ADRs were also associated with higher odds of receiving opioid prescriptions.

    • Conclusions:

    • Adults with chronic back pain and reported NSAID ADRs face increased risk for OUD and opioid analgesic use.
    • Allergy evaluation is essential for potential delabeling and improved pain management.
    • This highlights the importance of accurate allergy assessment in chronic pain patients.
    electronic health record
    hypersensitivity
    nonsteroidal anti-inflammatory drug (NSAID)
    opioid use disorder
    outpatient
    utilization