Disclosures: Amir Ahmadian, DO: Nothing to disclose

Objective: To study opiate use as a function of sex and depression among inpatient rehabilitation patients enrolled in an opiate weaning protocol study.

Design: Prospective cohort study

Setting: Inpatient rehabilitation unit at large urban academic hospital.

Participants: 49 inpatient rehabilitation patients admitted from November 2017 to September 2018.

Interventions: Opioid weaning protocol that attempts to decrease daily opioid intake based on a mathematical algorithm while maintaining adequate pain control for patients.

Main Outcome Measures: The relationship between mean daily opiate intake (in morphine equivalents) and patients’ sex and presence of depression using chart diagnosis or use of antidepressant medication as an indicator of depression.

Results: There was no statistically significant relationship between mean daily opiate intake (in morphine equivalents) and sex and depression. Depressed females consumed on average 50.3 morphine equivalents per day (-68.1 – 168.8, 95% CI, P=.3), non-depressed females consumed 26.5 morphine equivalents per day (-19.7 – 72.7, 95% CI, P=.3), depressed males consumed 40.8 morphine equivalents per day ( -43.7 – 125.2, 95% CI, P=.76), and non-depressed males consumed 35.0 morphine equivalents per day (-24.3 – 94.4, 95% CI, P=.76).

Conclusions: Although there was no statistically significant difference between mean daily opiate intake and patients’ sex and depression status, we noted that depressed patients of either gender had a higher average opioid intake for non-cancer pain compared to non-depressed patients. This finding is more notable in women. In our prior retrospective observational cohort analysis involving 154 patients, we found that depressed females consumed statistically significantly greater amounts of opiates for non-cancer pain compared to non-depressed females and all males independent of mean daily pain scores. These findings stress the importance of better assessment and management of symptoms associated with mental health disorders among inpatient rehabilitation patients to facilitate improved patient care. Limitations include small patient sample size, non-randomized study design and lack of direct control group.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/does-opioid-use-differ-as-a-function-of-sex-and-depression-using-an-opiate-weaning-protocol-in-inpatient-rehabilitation/