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Undetected Respiratory Depression in People with Opioid Use Disorder.
Tas, B; Kalk, N J; Lozano-García, M; Rafferty, G F; Cho, Psp; Kelleher, M; Moxham, J; Strang, J; Jolley, C J.
Afiliación
  • Tas B; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Addictions Department, King's College, London SE5 8BB, UK. Electronic address: basak.tas@kcl.ac.uk.
  • Kalk NJ; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Addictions Department, King's College, London SE5 8BB, UK; South London & Maudsley NHS Foundation Trust, SE5 8AZ, UK.
  • Lozano-García M; Biomedical Signal Processing and Interpretation group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST) & Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN) & Universitat Politècnica de
  • Rafferty GF; Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College, London SE1 1UL, UK.
  • Cho P; Department of Respiratory Medicine, King's College Hospital NHS Foundation Trust, King's Health Partners, London SE5 9RS, UK.
  • Kelleher M; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Addictions Department, King's College, London SE5 8BB, UK; South London & Maudsley NHS Foundation Trust, SE5 8AZ, UK.
  • Moxham J; Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College, London SE1 1UL, UK.
  • Strang J; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Addictions Department, King's College, London SE5 8BB, UK; South London & Maudsley NHS Foundation Trust, SE5 8AZ, UK.
  • Jolley CJ; Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College, London SE1 1UL, UK.
Drug Alcohol Depend ; 234: 109401, 2022 05 01.
Article en En | MEDLINE | ID: mdl-35306391
BACKGROUND: Opioid-related deaths are increasing globally. Respiratory complications of opioid use and underlying respiratory disease in people with Opioid Use Disorder (OUD) are potential contributory factors. Individual variation in susceptibility to overdose is, however, incompletely understood. This study investigated the prevalence of respiratory depression (RD) in OUD treatment and compared this to patients with chronic obstructive pulmonary disease (COPD) of equivalent severity. We also explored the contribution of opioid agonist treatment (OAT) dosage, and type, to the prevalence of RD. METHODS: There were four groups of participants: 1) OUD plus COPD ('OUD-COPD', n = 13); 2) OUD without COPD ('OUD', n = 7); 3) opioid-naïve COPD patients ('COPD'n = 13); 4) healthy controls ('HC'n = 7). Physiological indices, including pulse oximetry (SpO2%), end-tidal CO2 (ETCO2), transcutaneous CO2 (TcCO2), respiratory airflow and second intercostal space parasternal muscle electromyography (EMGpara), were recorded continuously over 40 min whilst awake at rest. Significant RD was defined as: SpO2%< 90% for > 10 s, ETCO2 per breath > 6.6 kPa, TcCO2 overall mean > 6 kPa, respiratory pauses > 10 s RESULTS: At least one indicator was observed in every participant with OUD (n = 20). This compared to RD episode occurrence in only 2/7 HC and 2/13 COPD participants (p < 0.05,Fisher's exact test). The occurrence of RD was similar in OUD participants prescribed methadone (n = 6) compared to those prescribed buprenorphine (n = 12). CONCLUSIONS: Undetected RD is common in OUD cohorts receiving OAT and is significantly more severe than in opioid-naïve controls. RD can be assessed using simple objective measures. Further studies are required to determine the association between RD and overdose risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Buprenorfina / Enfermedad Pulmonar Obstructiva Crónica / Sobredosis de Droga / Trastornos Relacionados con Opioides Tipo de estudio: Diagnostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Drug Alcohol Depend Año: 2022 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Buprenorfina / Enfermedad Pulmonar Obstructiva Crónica / Sobredosis de Droga / Trastornos Relacionados con Opioides Tipo de estudio: Diagnostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Drug Alcohol Depend Año: 2022 Tipo del documento: Article Pais de publicación: Irlanda