Opioid Abuse Disease Burden: Neurological Comorbidities Are an “Underappreciated Contributor”

Neurological comorbidities appear to be a frequent and underappreciated contributor to opioid abuse disease burden among hospitalized patients with opioid abuse, according to new findings presented at the American Neurological Association’s 145th Annual Meeting.

“Comorbidities traditionally ascribed to opioid abuse were not found in this study,” the authors of the study noted. “The importance of neurological comorbidities should be considered in the public health discussions surrounding opioid epidemic crisis,” they added.

The authors arrived at their conclusion following an analysis of discharge data (N = 34,414) from the University of Kentucky HealthCare Enterprise from October 1, 2016, to September 30, 2017. ICD-10 code F11 was used to identify individuals with opioid abuse (n = 2183). Of these patients, the authors selected 360 for chart review, and patients were matched according to age, race, gender, and residence in an urban or rural area.

Each investigator was randomly assigned to assess 90 records. No statistically significant disagreement between raters was identified.

A total of 347 of the 360 patients were assessed (13 had no documentation of opioid abuse). The prevalence of opioid abuse among patients who had been discharged was 6.3% and was found to be higher among younger patients. Approximately 55.4% of patients were women, 95.3% were Caucasian, and 29.1% lived in urban areas. The authors found that 179 (51.6%) patients had any neurological comorbidities. Types of comorbidities included encephalopathy causes (n = 130; 72.63%), neuromuscular disorders (n = 41; 23.46%), seizure disorders (n = 23; 12.85%), spine disorders (n = 23; 12.85), strokes (n = 20, 11.17%), infections of the central nervous system (n = 3; 1.67%), and movement disorders (n = 2; 1.12%). Notably, the decision to admit patients was affected by neurological comorbidity among 162 patients (46.69%).

The authors did not observe posterior reversible encephalopathy syndrome, leukoencephalopathy, or transverse myelitis among the study population.

—Christina Vogt

Nelson K, Dolbec K, Watson W, Yuan H, Ibraheem M. Neurological comorbidities in hospitalized patients with opioid abuse. Ann Neurol. 2020;88(Suppl. 20). doi:10.1002/ana.25865