Riesgo de uso indebido de opioides prescritos en pacientes con dolor crónico no oncológico en un hospital de sistema mutual en Chile

Abstract

Introduction: In some countries, the abuse of opioids is increasing considerably, however, in Chile there is no official data. The aim of this study was to identify and to describe all patients in treatment for chronic non-cancer pain (CNCP) at risk of opioid misuse within the Rehabilitation Department of Hospital del Trabajador, Santiago de Chile, from August 14, 2018 to February 02, 2020. Material and methods: A descriptive cross-sectional study was carried out in 120 opioid users with a diagnosis of CNCP. A structured survey was applied to characterize them based on demographic, clinical data, opioid misuse (COMM®), and health-related quality of life (SF 36 v.2). Results: We found 35 patients (29.17 %) with risk of opioid abuse. The median age was 50.7 years. The mean time of opioid consumption was 32.4 months. Tramadol in association with paracetamol was the most widely used opioid. Statistically significant increased misuse was observed in patients diagnosed with amputation (p-value = 0.026) and alcohol use (p-value = 0.003). Furthermore, misuse was significantly associated with a lower score in the domains of physical role (p-value = 0.0299), general health (p-value = 0.0166), vitality (p-value = 0), mental health (p-value = 0) and global score of the SF 36 scale (p-value = 0.0003). Conclusion: Our study showed a 29,1 % prevalence of risk of opioid misuse, which is similar to that found in the literature. There is a relationship between opioid misuse and alcohol consumption, amputation diagnosis, and a lower quality of life, which generates greater disability in these patients. This is the first report in Chile.