Posters
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Family and Community Medicine
Academic Level (Author 3)
Faculty
Discipline/Specialty (Author 3)
Family and Community Medicine
Discipline Track
Patient Care
Abstract
Background and objectives: Opioids have been used broadly for pain control in patients with intense pain in the hospital setting. Hydromorphone is one of the semisynthetic opioids with high potency that is occasionally chosen for better pain control when non-opioids and natural opioids fail to control pain1. And sometimes it is preferred in patients with hemodialysis because of the pharmacokinetics of hydromorphone which elimination is achieved easily by dialysis2. It is unknown whether its potential for abuse is higher than other opioids3,4. However, the authors experienced three cases of opioid dependence induced by using hydromorphone for pain control.
Methods: Retrospective case series (n = 3).
Case presentation:
Case 1: A 35-year-old paraplegic male with spinal cord injury developed opioid dependence after using hydromorphone during several hospitalizations due to UTI and infection of the decubitus ulcer. A history of depression after the loss of his mother was overlooked.
Case 2: A 41-year-old male with ESRD on hemodialysis was introduced to hydromorphone during the treatment of diabetic foot gangrene and developed opioid dependence. A history of cocaine abuse was missed during the evaluation.
Case 3: A 36-year-old female with SLE and lupus nephritis introduced hydromorphone as pain control for multiple joint pain while a hospital stays due to hemodialysis. Decreased hepatic metabolism in liver cirrhosis was not considered initially5.
Conclusion: Before using hydromorphone, evaluating risk factors of opioid dependence6, reviewing risk factors7 hindering the metabolism of hydromorphone, and assessment with a multidisciplinary approach should be done even in the acute care setting.
Presentation Type
Poster
Recommended Citation
Yi, Changho; Faye, Justin; and Cano, Jose, "Opioid dependence induced by hydromorphone use in the acute care hospital setting." (2024). Research Colloquium. 38.
https://scholarworks.utrgv.edu/colloquium/2023/posters/38
Included in
Opioid dependence induced by hydromorphone use in the acute care hospital setting.
Background and objectives: Opioids have been used broadly for pain control in patients with intense pain in the hospital setting. Hydromorphone is one of the semisynthetic opioids with high potency that is occasionally chosen for better pain control when non-opioids and natural opioids fail to control pain1. And sometimes it is preferred in patients with hemodialysis because of the pharmacokinetics of hydromorphone which elimination is achieved easily by dialysis2. It is unknown whether its potential for abuse is higher than other opioids3,4. However, the authors experienced three cases of opioid dependence induced by using hydromorphone for pain control.
Methods: Retrospective case series (n = 3).
Case presentation:
Case 1: A 35-year-old paraplegic male with spinal cord injury developed opioid dependence after using hydromorphone during several hospitalizations due to UTI and infection of the decubitus ulcer. A history of depression after the loss of his mother was overlooked.
Case 2: A 41-year-old male with ESRD on hemodialysis was introduced to hydromorphone during the treatment of diabetic foot gangrene and developed opioid dependence. A history of cocaine abuse was missed during the evaluation.
Case 3: A 36-year-old female with SLE and lupus nephritis introduced hydromorphone as pain control for multiple joint pain while a hospital stays due to hemodialysis. Decreased hepatic metabolism in liver cirrhosis was not considered initially5.
Conclusion: Before using hydromorphone, evaluating risk factors of opioid dependence6, reviewing risk factors7 hindering the metabolism of hydromorphone, and assessment with a multidisciplinary approach should be done even in the acute care setting.