News | Clinical Trials | January 11, 2018

Radiologists are seeing more and more opioid abuse-related complications in patients and need to play a bigger role in these patients' care, study says

Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.


January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opioid use disorders, according to results from a 12-year study presented at the annual meeting of the Radiological Society of North America (RSNA), Nov. 26-Dec. 1 in Chicago. Researchers said the findings underscore the need for radiologists to play a role in the care continuum for these patients.

Substance use disorders of highly addictive opioids like heroin, fentanyl and oxycodone continue to skyrocket in the U.S. Intravenous opioid use disorders are a major contributor to the drug overdoses that are the leading cause of injury and death in the United States, according to the Department of Health and Human Services. Patients prescribed opioid medications for pain management of a medical condition often develop dependence, and many go from crushing and injecting pills to injecting heroin as a less expensive way to deal with their disease, said senior study author Efren J. Flores, M.D., emergency radiologist at Massachusetts General Hospital in Boston.

“We’ve seen a dramatic increase in the past year of patients coming into the emergency department with complications related to substance use disorders,” he said. “The patient population is underserved. By the time we see them, they have more advanced complications because they’re hesitant to ask for help due to social stigmas.”

For the study, Flores and colleagues looked at the prevalence and type of complications related to substance use disorders in patients arriving at emergency radiology. The study group included 1,031 patients imaged from 2005 to 2016 for substance use-related complications. Of all the patients, 66 percent were men, 78 percent were white and the mean age was 36 years.

The results showed a high prevalence of complications among the patients, including symptoms related to injections, respiratory issues and back pain.

“Complications were most frequently related to skin and soft tissue infections caused by the use of non-sterile needles,” Flores said. “In some cases, we found septic emboli in the lung or brain. As these patients start having to access larger veins, they become more prone to these types of infections.”

There were 1,673 imaging exams performed, including 779 X-rays, 544 computed tomography scans (CTs), 292 magnetic resonance imaging scans (MRIs) and 58 ultrasounds. Imaging results often provided critical information, such as when physicians changed the management plan for a patient with a substance-abuse-related lumbar spine infection after CT scans showed the involved nerves.

History of opioid prescriptions before the first imaging exam was present in 310 (30 percent) cases with a mean of 10 prescriptions per patient. History of opioid prescriptions was significantly higher in women (36 percent, 128/352), than men (27 percent, 182/679). Mean time from opioid prescription to first imaging exam was 51 months – significantly shorter in men (45 months) than women (51 months).

Overall, 121 of the 1,031 patients, or 11.7 percent, died before the end of the study period. The mortality rate was 14 percent for patients with a positive imaging diagnosis of substance-abuse-related complications – significantly higher than the 10 percent rate for patients with no such history. Five-year mortality rates were also higher in patients with prior opioid prescriptions and with imaging complications.

The prevalence of substance use disorder in patients presenting to emergency radiology provides radiologists a unique opportunity to “look beyond the reading room, and see other ways we can help,” Flores said. For instance, radiologists can encourage patients to use sterile needles, inform them about needle exchange programs and advise them to use alcohol at the injection site to avoid infections. Radiologists can also help steer patients into programs or connect them with recovery coaches, both in the hospital and community, to help them with their illness.

“Radiology is central to patient care in the emergency department setting,” Flores said. “We need to be actively advocating for these patients and giving them an opportunity to take steps into recovery.”

Co-authors are Renata R. Almeida, M.D., Mohammad Mansouri, M.D., M.P.H., Ajay K. Singh, M.D., and Michael H. Lev, M.D.

For more information: www.rsna.org

Related Content

Key RSNA 2017 Study Presentations, Trends and Video
 


Related Content

News | Artificial Intelligence

March 1, 2024 — Royal Philips, a global leader in health technology, and magnetic resonance imaging (MRI) software ...

Time March 01, 2024
arrow
News | Artificial Intelligence

February 29, 2024 — AIxSCAN, Inc., a Sunnyvale, CA-based developer of a next generation artificial intelligence (AI) ...

Time February 29, 2024
arrow
News | Artificial Intelligence

February 27, 2024 — Median Technologies announced that the Company will be participating and speaking at the premier ...

Time February 27, 2024
arrow
News | X-Ray

February 26, 2024 — AIxSCAN, Inc. began clinical trials in late 2023. The AIxSCAN, Inc. team is very pleased with the ...

Time February 26, 2024
arrow
News | Radiology Imaging

February 23, 2024 — Can dual-energy tomosynthesis be performed portably? This is one of the topics to be discussed by KA ...

Time February 23, 2024
arrow
News | PACS

February 22, 2024 — aycan, a recognized leader in medical imaging, announced that Enspectra Health used aycan’s PACS ...

Time February 22, 2024
arrow
News | Breast Imaging

February 22, 2024 — The FAST-Forward randomized trial from the UK found that ultrahypofractionated whole breast ...

Time February 22, 2024
arrow
News | Cardiac Imaging

February 12, 2024 — According to the American Journal of Roentgenology (AJR), free-breathing cine-deep learning (DL) may ...

Time February 12, 2024
arrow
Videos | RSNA

At RSNA23, Imaging Technology News (ITN) spoke with Bhvita Jani, principal analyst at Signify Research, about ...

Time February 07, 2024
arrow
News | Artificial Intelligence

February 6, 2024 — Medical imaging AI innovator, Qure.ai, has received breakthrough device designation from the Food and ...

Time February 06, 2024
arrow
Subscribe Now