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Opioid, Alcohol, and Cannabis Misuse Among Patients With Hidradenitis Suppurativa
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
Patients with hidradenitis suppurativa (HS) experience chronic pain and have significant physical, emotional and psychological disease impact. These patients may be at risk for substance abuse.
OBJECTIVE
To evaluate substance use disorder (SUD) among HS patients in the United States.
METHODS
Cross-sectional analysis of adult HS patients (n = 32,625) identified using electronic health records data from a population-based sample of over 50 million patients.
RESULTS
The prevalence of SUD among patients with HS was 4.0% (1,315/32,625), compared to 2.0% (195,260/9,581,640) for patients without HS (p<0.001). The most common forms of substance misuse among HS patients were alcohol (630/1,315; 47.9% of SUD cases), followed by opioids (430/1,315, 32.7% of SUD cases) and cannabis (430/1,315, 29.7% of SUD cases). HS patients had 1.50 [95% CI 1.42-1.59] times the adjusted odds of SUD compared to patients without HS. HS patients had significantly greater odds of SUD across demographic subgroups. The association between HS and SUD was generally stronger for patients aged 45-64 years, non-whites, privately-insured, and those without depressive or anxiety disorder.
LIMITATIONS
SUD may not be accurately diagnosed.
CONCLUSION
Patients with HS have higher odds of SUD and may benefit from periodic screening for substance abuse.
Additional Info
Disclosure statements are available on the authors' profiles:
Opioid, Alcohol, and Cannabis Misuse Among Patients With Hidradenitis Suppurativa: A Population-Based Analysis in the United States
J Am Acad Dermatol 2018 Feb 27;[EPub Ahead of Print], A Garg, V Papagermanos, M Midura, A Strunk, J MersonFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This study on opioid, alcohol, and cannabis misuse among patients with hidradenitis suppurativa in the United States is truly an impactful study. The database covers a population of over 50 million patients, among whom more than 30,000 HS patients were identified. The findings were quite noteworthy. The prevalence of substance misuse in hidradenitis suppurativa patients is double that of those without hidradenitis suppurativa (4.0% vs 2.0%). Surprisingly, within each demographic subgroup analyzed, the association between HS and substance misuse was stronger among those who were privately insured and those without a prior history of depression or anxiety.
We agree with the authors that these results strongly suggest the tremendous negative impact of hidradenitis suppurativa as a disease, to the point that even the usual parameters such as socioeconomic status and history of prior psychiatric disorders became overwhelmed. It is clearly of utmost importance for dermatologists to fully appreciate the negative life impact of hidradenitis suppurativa, beyond the obvious signs and symptoms, such as pain. Moreover, although pain management is an important aspect of care for these patients, dermatologists must understand the potential risks of their prescriptions. These findings potentially raise the question of whether dermatologists could consider learning to screen such patients at risk for substance misuse. Given that 32.7% of the hidradenitis suppurativa patients with substance use disorder were found to misuse opioids, in doing so, our specialty could possibly contribute to the control of the current opioid overdose epidemic in the United States.