Substance Use Disorders in Later Life: A Review and Synthesis of the Literature of an Emerging Public Health Concern

Yarnell, Stephanie; Li, Luming; MacGrory, Brian; Trevisan, Louis; Kirwin, Paul D.

doi:10.1016/j.jagp.2019.06.005

Cited by 64 publications

(38 citation statements)

References 84 publications

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“…is is also lower than the rate that was found in a similar study performed on patients undergoing lower extremity bypass (0.63%) [24] and lower than the 0.81% that has been reported for the general population [24,25]. e lower rate observed in our cohort likely reflects the fact that patients undergoing total joint arthroplasty are typically older than the general population, and while substance abuse is becoming more common in a geriatric population [26], it remains much more commonly encountered in younger populations. is is also reflected in our two cohorts.…”

Section: Discussioncontrasting

confidence: 60%

The Impact of Preoperative Opioid Use Disorder on Complications and Costs following Primary Total Hip and Knee Arthroplasty

Wilson

Farley

Aizpuru

et al. 2019

Advances in Orthopedics

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Introduction. Multiple studies have demonstrated that patients taking opioids in the preoperative period are at elevated risk for complications following total hip (THA) and knee (TKA) arthroplasty. However, the incidence and impact of opioid use disorder (OUD) among these patients—both clinically and fiscally—remain unknown. The purpose of this study was to investigate this relationship. Methods. The Nationwide Readmission Database (NRD) was used to identify patients undergoing THA and TKA from 2011 to 2015. Coarsened exact matching was used to statistically match the OUD and non-OUD cohorts. Further analysis was then conducted on matched cohorts with multivariate analysis. The incidence of OUD was also determined, and the costs associated with this comorbidity were calculated. Results. The incidence of OUD in arthroplasty patients increased 80% over the study period. OUD patients had higher odds of prosthetic joint infection (OR 1.55, 95% CI 1.23–1.94), wound complication (OR 1.40, 95% CI 1.12–1.76), prosthetic complication (OR 1.37, 95% CI 1.10–1.70), and revision surgery (OR 1.47, 95% CI 1.19–1.81). OUD patients also had longer length of stays (TKA: +0.67 days; THA: +1.09 days), higher readmission (OR 1.60, 95% CI 1.43–1.79), and increased 90-day costs (TKA: +$3,602 [95% CI $3,138–4,065]; THA: +4,527 [95% CI $3,593–4,920). Conclusion. Opioid use disorder is becoming a more common comorbidity among THA and TKA patients. This is concerning as it represents a significant risk factor for postoperative complication. It additionally confers increased perioperative costs. Patients with OUD should be counseled on their elevated risk, and future work will be needed to determine if this is a modifiable risk factor.

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Section: Discussioncontrasting

confidence: 60%

The Impact of Preoperative Opioid Use Disorder on Complications and Costs following Primary Total Hip and Knee Arthroplasty

Wilson

Farley

Aizpuru

et al. 2019

Advances in Orthopedics

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“…In a best-case scenario, transitioning substance use disorder services for older adults to a telehealth model would be a challenge since older adults have less familiarity with technology and experience in communicating via a telehealth platform. As noted by Cimarolli et al and other researchers, the combination of social isolation and advanced age decrease the likelihood that older adults with substance use disorders will successfully access treatment 5 . At a policy level, many of the guidelines that have been modified during the pandemic need to be made permanent to ensure providers that the investment in both hardware and personnel training is prudent and financially responsible.…”

mentioning

confidence: 93%

Increasing Participation in a Substance Misuse Programs: Lessons Learned for Implementing Telehealth Solutions During the COVID-19 Pandemic

Rosen

2021

The American Journal of Geriatric Psychiatry

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“…Substance use disorder is reckoned as an emerging national health concern [1]. It is expected that about 5.7 million older adults will have a substance abuse disorder by 2020 [2]. Substance abuse is often accompanied by non-adherence to medical therapy.…”

Section: Introductionmentioning

confidence: 99%

Substance use disorders: diagnosis and management for hospitalists

Pasha

Chowdhury

Sadiq

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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Substance use disorder is a significant health concern. Hospitalists manage patient with various forms of substance use disorder on a daily basis. In this review, we have tried to synthesize evidence together to give a brief, yet succinct, review of commonly encounters disorders; alcohol intoxication and withdrawal, opioid intoxication and withdrawal, cocaine intoxication and methamphetamine intoxication. We describe clinical features, diagnosis and management, which would serve as a great resource for hospitalist when managing these complicated patients.

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Substance Use Disorders in Later Life: A Review and Synthesis of the Literature of an Emerging Public Health Concern

Cited by 64 publications

References 84 publications

The Impact of Preoperative Opioid Use Disorder on Complications and Costs following Primary Total Hip and Knee Arthroplasty

The Impact of Preoperative Opioid Use Disorder on Complications and Costs following Primary Total Hip and Knee Arthroplasty

Increasing Participation in a Substance Misuse Programs: Lessons Learned for Implementing Telehealth Solutions During the COVID-19 Pandemic

Substance use disorders: diagnosis and management for hospitalists

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