Does Socioeconomic Status or Methamphetamine Use Affect Discharge Opioid Requirements in Burn-Injured Patients?

Abstract

Methamphetamine (MA) use is associated with lower socioeconomic status (SES) and increased opioid use. Though MA use itself has been linked to larger burn injuries and increased length of stay, studies examining the effect of SES on opioid use in this patient population remain limited. The aim of this work was to examine how both SES and/or MA use in burn patients affected discharge opioid requirements. Records of burn patients admitted to an ABA-verified burn center were reviewed from January 2016 to December 2017. Patients were grouped into MA-positive (MPOS) or negative (MNEG) groups based on admission urine toxicology screening. Pain scores, oral morphine opioid equivalents (OEs), and adjunct pain medication use reported within 24 hours of discharge were examined. SES was determined by zip code. No difference was found between MPOS and MNEG groups regarding discharge OEs (P = .4), OE/TBSA (P = .79), or pain score (P = .09). Low SES was more prevalent in MPOS patients (P < .0001) but low SES was not a predictor of discharge OEs (P = .7), OE/TBSA (P = .7), or pain score (P = .15). Discharge OEs and OE/TBSA requirements correlated with discharge pain score (P < .0001) and LOS (P < .01), but not SES. Multivariate linear regression found that MNEG status (P = .005), pain score (P < .0001), concurrent use of benzodiazepines and gabapentin (P < .001), but not low SES, were independently associated with increased OEs. Although lower SES was seen in patients using MA, SES was not associated with discharge opioid use or pain scores. Additional work will be necessary to determine factors affecting opioid use in this population.