title: Is Admission to the Intensive Care Unit Associated With Chronic Opioid Use? A 4-Year Follow-Up of Intensive Care Unit Survivors.
abstract: OBJECTIVE
  To describe opioid use before and after intensive care unit (ICU) admission and to identify factors associated with chronic opioid use upto 4 years after ICU discharge.
  
  
  METHODS
  Retrospective review of adult patients admitted to the ICU at a tertiary care center between January 1, 2005, to December 31, 2008. We defined "nonuser," "intermittent," and "chronic" opioid status by abstinence, use in <70%, and >70% of days for a given time period, respectively. We assessed opioid use at 3 months prior to ICU admission, at discharge, and annually for upto 4 years following ICU discharge.
  
  
  RESULTS
  A total of 2595 ICU patients were included for surgical (48.6%), medical (38.4%), and undetermined (13%) indications. The study population included both elective (26.9%) and emergent (73.1%) admissions. Three months prior to ICU admission, 76.9% were nonusers, 16.9% used opioids intermittently, and 6.2% used opioids chronically. We found an increase in nonuser patients from 87.8% in the early post-ICU period to 95.6% at 48-month follow-up. Consequently, intermittent and chronic opioid use dropped to 8.6% and 3.6% at discharge and 2.6% and 1.8% at 48-month follow-up, respectively. Prolonged hospital length of stay was associated with chronic opioid use.
  
  
  CONCLUSIONS
  Admission to ICU and duration of ICU stay were not associated with chronic opioid use.
authors.affiliation: 1 Department of Critical Care Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.|2 Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Yaffe
authors.affiliation: 1 Department of Critical Care Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.|3 Trauma Nova Scotia, Halifax, Nova Scotia, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green
authors.affiliation: 1 Department of Critical Care Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.|3 Trauma Nova Scotia, Halifax, Nova Scotia, Canada.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Butler
authors.affiliation: 1 Department of Critical Care Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.|4 Department of Anesthesia, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Tobias
authors.initials: T
authors.lastname: Witter
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid
keywords: chronic pain; intensive care unit; opioid