Hospitalizations for Poisoning by Prescription Opioids, Sedatives, and Tranquilizers

Coben, Jeffrey H.; Davis, Stephen M.; Furbee, Paul M.; Sikora, Rosanna; Tillotson, Roger; Bossarte, Robert M.

doi:10.1016/j.amepre.2010.01.022

Cited by 152 publications

(121 citation statements)

References 14 publications

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“…Intentional poisoning by opiates, sedatives, and tranquilizers increased by 130% compared to intentional poisonings by other substances, which increased by 53%, over a period of seven years (Coben et al, 2010), corroborating the results related to drugs used in the treatment of the central nervous system (CNS).…”

Section: T H E V E R I F I C a T I O N T H A T T H E O C C U R R E N supporting

confidence: 65%

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Abreu

Ferreira

et al. 2013

Braz. J. Pharm. Sci.

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A cross-sectional study of secondary data/information obtained from the Hospital Information System (HIS) spanning the years 2008 -2009 was performed. The distribution of the main hospital admissions by gender, age, color/race, region and federal unit of residence, average expenditure and average length of hospital stay, year of hospitalization and mortality rates (MR) were studied. The data collected were tabulated by TabNet and keyed into Microsoft Excel 2007. It was verified that elderly males (54.3%), from 60 to 69 years old (50.6%), nonwhites (36.3%) and residents of Southeast and North regions of the country had the highest rates of hospitalization. Seniors were hospitalized for an average of 4.8 days, and the major causes were exposure to alcohol (43.7%) and to drugs (33.9%). Expenses related to hospital admissions were, on average, R$ 529,817.70. The highest mortality rates were recorded among females (MR = 4.34), in elderly, 80 years or older (MR = 10.16) and Caucasians (MR = 3.95), where pharmacological substances with action on the Autonomic Nervous System were the leading cause of death. There are demographic differences in morbi-mortality of these elderly since, although men and younger elderly were the main victims, women and elderly of advanced age have greater mortality. The leading causes of hospitalization were alcohol and drugs.Uniterms: Hospital Information System. Elderly patients/hospitalization. Medicines/inappropriated use. Hospitalization/rates. Poisoning. Alcohol/use.Realizou-se um estudo transversal de dados secundários obtidos no Sistema de Informação Hospitalar (SIH), nos anos 2008/2009. Estudou-se a distribuição das principais internações segundo sexo; faixa etária; cor/ raça; região e unidade federativa de residência; valor médio pago e média de permanência das internações hospitalares; ano de internação e as taxas de mortalidade (TM). Os dados coletados foram tabulados por meio do TabNet e transcritos para o Programa Microsoft Excel® 2007. Verificou-se que idosos do sexo masculino (54,3%), com 60 e 69 anos de idade (50,6%), não brancos (36,3%) e residentes nas regiões Sudeste e Norte do País apresentaram os maiores percentuais de internação hospitalar. Idosos ficam em média 4,8 dias internados, sendo as principais causas a exposição ao álcool (43,7%) e a medicamentos (33,9%). Os gastos com as internações equivaleram a R$ 529.817,70. As maiores taxas de mortalidade foram registradas no sexo feminino (TM=4,34), em idosos entre 80 anos e superior (TM=10,16) e pessoas brancas (TM=3,95), sendo as substâncias farmacológicas de ação sobre o Sistema Nervoso Autônomo maiores causas do óbito. Existem diferenças demográficas na morbimortalidade desses idosos, visto que apesar de homens e idosos mais jovens serem as principais vítimas, mulheres e idosos com idade mais avançada morrem mais. Sendo as principais causas de internação o álcool e os medicamentos.Unitermos: Sistema de Informação Hospitalar Paciente idosos/hospitalização. Medicamentos/uso inapropriado. Hospitalização/causas. Envenena...

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Section: T H E V E R I F I C a T I O N T H A T T H E O C C U R R E N supporting

confidence: 65%

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Abreu

Ferreira

et al. 2013

Braz. J. Pharm. Sci.

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“…(3) increase in antibiotic resistance; (4) increase in risk of adverse events directly from the medication, as well as from drug-food and drug-drug interactions. 2 A significant number of emergency department visits and the majority of overdose deaths are associated with the diversion of prescription drugs.…”

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confidence: 99%

Prescription Medication Borrowing among Adult Patients at an Urban Medical Center

et al. 2011

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Prescription medication borrowing can result in adverse health outcomes. We aimed to study the patterns of borrowing prescription medications in an adult urban population seeking healthcare in the outpatient, emergency, and inpatient units of an urban medical center. Participants indicated whether they (1) had a primary care doctor, medical insurance, a prior history of substance abuse, psychiatric disorders, or chronic pain; and (2) had borrowed a prescription medication. If so, they noted the medication obtained, source, frequency of use, and reasons why they had not obtained a prescription from a licensed medical provider. Of the 641 participants, most were African American (75%), urban residents (75%), high school educated or less (71%), and lacked full-time employment (68%). Many had health insurance (90%) and had recently seen their primary medical provider (75%). Eighteen percent reported ever borrowing a prescription medication. On multivariate analysis, history of chronic pain was marginally associated with increased medication borrowing (odds ratio [OR] = 1.58) while having Medicare insurance (OR = 0.436) or a primary care medical provider routinely ask about medication usage (OR = 0.589) were significantly associated with decreased medication borrowing. The most commonly obtained medications were for pain (74%), usually in the form of opioids, and were obtained from a family member (49%) or friend (38%). Thirty-five percent of those who borrowed medications did so more than once a year, with lack of convenient access to medical care the most frequently cited reason for use (67%). Only a third of those who borrowed medications had informed their primary medical providers of the behavior. In conclusion, borrowing prescription medications is a common behavior in the population studied. Further research is warranted into interventions to reduce such use, especially the impact of methods to improve the convenience of contacting licensed medical providers.

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“…CNS-depressant drugs are among the most commonly ingested substances in self- 63 poisoning in the United States , United 64 65 Kingdom and Australia . According to the tertiary care clinical toxicology admission s t a t i s t i c s i n A u s t r a l i a , a t y p i c a l antipsychotics, benzodiazepines and opioids Most of the patients hospitalised with CNS depressant overdose are managed in emergency departments or general medical units and less frequently in specialised clinical toxicology departments.…”

Section: O G N I T I V E To X I C I T Y O F S E D a T I V E P S Y Cmentioning

confidence: 99%

Cognitive toxicity: from pesticides to pharmaceuticals

Dassanayake

2017

SL J. Med.

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Impairment of cognitive functions following neurotoxic exposure is collectively termed cognitive toxicity. This oration is based on a series of studies carried out over last 12 years on cognitive toxicity of two groups of substances, viz. organophosphate (OP) pesticides and sedative psychotropic drugs.OP pesticide poisoning is a major clinical and public health problem in South Asia. OPs act as cholinesterase inhibitors, and bring about acute neurological deficits following exposure. Using neurophysiological and neuropsychological techniques, we assess long-term neurocognitive deficits of OPs, a less known yet important adverse effect of OP exposure. The findings hitherto indicate both acute large-dose poisoning and subclinical occupational exposure are associated with long-term cognitive impairment.In the same way the pesticide use and misuse are common in agricultural communities, use and misuse of sedative psychotropic medications are common in urbanised societies. Sedative drugs, even in therapeutic doses impair driving and underlying cognitive functions, and increase the risk of traffic accidents. When taken in overdose, these drugs have cognitively impairing effects that last beyond clinical recovery from acute poisoning. These patients are more prone to traffic crashes at least up to 4 weeks following exposure, and the cognitive recovery over this period mirrors the crash risk at different post-overdose time points. The above findings raise a number of clinical and medico legal implications in post-discharge management of patients with sedative drug overdose.As the agricultural communities transform into urban industrialised societies in Sri Lanka, the pattern of poisoning changes from agrochemicals into pharmaceuticals, particularly psychotropic dugs. The two lines of research discussed above highlight how this changing social fabric poses new challenges for the neurophysiologists, neurologists and psychiatrists who study cognition and apply their findings in clinical settings. Our latest work in generating age-, sex-and education-adjusted norms for cognitive tests for Sri Lankans, would set the foundation in interpreting the cognitive test results of clinical populations.

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Hospitalizations for Poisoning by Prescription Opioids, Sedatives, and Tranquilizers

Cited by 152 publications

References 14 publications

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Prescription Medication Borrowing among Adult Patients at an Urban Medical Center

Cognitive toxicity: from pesticides to pharmaceuticals

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