The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study
Introduction The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers wi...
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| creator | Patel, Urvish K Malik, Preeti Shah, Dhaivat Sharma, Ashish Bhela, Jatminderpal Chauhan, Bindi Patel, Deepkumar Khan, Nashmia Kapoor, Ashish Kavi, Tapan |
| description | Introduction
The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches.
Methodology
We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student’s t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders.
Results
A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p |
| doi_str_mv | 10.7759/cureus.9743 |
| format | Article |
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The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches.
Methodology
We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student’s t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders.
Results
A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p<0.0001). Opioid abusers with headaches were more likely to be younger (43 years old vs. 50 years old), men (30.17% vs. 24.78%), white (80.83% vs. 73.29%), Medicaid recipients (30.15% vs. 17.03%), and emergency admissions (85.4% vs. 78.51%) as compared to opioid non-abusers with headaches (p<0.0001). Opioid abusers with headaches had higher prevalence and odds of morbidity (4.06% vs. 3.70%; adjusted odds ratio [aOR]: 1.48; 95% CI: 1.39-1.59), severe disability (28.14% vs. 22.43%; aOR: 1.58; 95% CI: 1.53-1.63), and discharge to non-home location (17.13% vs. 18.41%; aOR: 1.35; 95% CI: 1.30-1.40) as compared to non-abusers. US hospitalizations in years 2013-2014 showed the migraine (OR: 1.61; 95% CI: 1.57-1.66), TTH (OR: 1.43; 95% CI: 1.22-1.66), and CH (OR: 1.34; 95% CI: 1.01-1.78) were linked with opioid abuse.
Conclusion
Through this study, we found that the prevalence of migraine, TTH, and CH was higher in opioid abusers than non-abusers. Opioid abusers with primary headache disorders had higher odds of morbidity, severe disability, and discharge to non-home location as compared to non-abusers.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.9743</identifier><identifier>PMID: 32944458</identifier><language>eng</language><publisher>Palo Alto (CA): Cureus</publisher><subject>Epidemiology/Public Health ; Neurology ; Public Health</subject><ispartof>Curēus (Palo Alto, CA), 2020-08, Vol.12 (8), p.e9743-e9743</ispartof><rights>Copyright © 2020, Patel et al. 2020 Patel et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c288t-ac21a048664ebc405e69da78d542ab5b2734407e0b0e38acd328ab2a295ea3c3</citedby><cites>FETCH-LOGICAL-c288t-ac21a048664ebc405e69da78d542ab5b2734407e0b0e38acd328ab2a295ea3c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489777/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489777/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids></links><search><creatorcontrib>Patel, Urvish K</creatorcontrib><creatorcontrib>Malik, Preeti</creatorcontrib><creatorcontrib>Shah, Dhaivat</creatorcontrib><creatorcontrib>Sharma, Ashish</creatorcontrib><creatorcontrib>Bhela, Jatminderpal</creatorcontrib><creatorcontrib>Chauhan, Bindi</creatorcontrib><creatorcontrib>Patel, Deepkumar</creatorcontrib><creatorcontrib>Khan, Nashmia</creatorcontrib><creatorcontrib>Kapoor, Ashish</creatorcontrib><creatorcontrib>Kavi, Tapan</creatorcontrib><title>The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study</title><title>Curēus (Palo Alto, CA)</title><description>Introduction
The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches.
Methodology
We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student’s t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders.
Results
A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p<0.0001). Opioid abusers with headaches were more likely to be younger (43 years old vs. 50 years old), men (30.17% vs. 24.78%), white (80.83% vs. 73.29%), Medicaid recipients (30.15% vs. 17.03%), and emergency admissions (85.4% vs. 78.51%) as compared to opioid non-abusers with headaches (p<0.0001). Opioid abusers with headaches had higher prevalence and odds of morbidity (4.06% vs. 3.70%; adjusted odds ratio [aOR]: 1.48; 95% CI: 1.39-1.59), severe disability (28.14% vs. 22.43%; aOR: 1.58; 95% CI: 1.53-1.63), and discharge to non-home location (17.13% vs. 18.41%; aOR: 1.35; 95% CI: 1.30-1.40) as compared to non-abusers. US hospitalizations in years 2013-2014 showed the migraine (OR: 1.61; 95% CI: 1.57-1.66), TTH (OR: 1.43; 95% CI: 1.22-1.66), and CH (OR: 1.34; 95% CI: 1.01-1.78) were linked with opioid abuse.
Conclusion
Through this study, we found that the prevalence of migraine, TTH, and CH was higher in opioid abusers than non-abusers. Opioid abusers with primary headache disorders had higher odds of morbidity, severe disability, and discharge to non-home location as compared to non-abusers.</description><subject>Epidemiology/Public Health</subject><subject>Neurology</subject><subject>Public Health</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNpVkU9LxDAQxYMorqgnv0COgnRNk3STehD8v8KiggsewzQZ3Ui3qUmr7Le3uiJ6mhnmx5vHPEIOcjZWqiiPbR-xT-NSSbFBdng-0ZnOtdz804_IfkqvjLGcKc4U2yYjwUspZaF3yNN8gfS-9cE7etV6h0tvKTSOPkS_hLiiUwQHdoAufQrRYUwn9IzeQedD8zHw9CG0ff09ZueQ0NHHrnerPbL1DHXC_Z-6S-bXV_OLaTa7v7m9OJtllmvdZWB5DkzqyURiZSUrcFI6UNoVkkNVVFwJKZlCVjEUGqwTXEPFgZcFgrBil5yuZdu-WqKz2HQRatOuzZsA3vzfNH5hXsK7UVKXSqlB4PBHIIa3HlNnlj5ZrGtoMPTJ8OFPQueDnQE9WqM2hpQiPv-eyZn5CsOswzBfYYhP4YF9mg</recordid><startdate>20200814</startdate><enddate>20200814</enddate><creator>Patel, Urvish K</creator><creator>Malik, Preeti</creator><creator>Shah, Dhaivat</creator><creator>Sharma, Ashish</creator><creator>Bhela, Jatminderpal</creator><creator>Chauhan, Bindi</creator><creator>Patel, Deepkumar</creator><creator>Khan, Nashmia</creator><creator>Kapoor, Ashish</creator><creator>Kavi, Tapan</creator><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200814</creationdate><title>The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study</title><author>Patel, Urvish K ; Malik, Preeti ; Shah, Dhaivat ; Sharma, Ashish ; Bhela, Jatminderpal ; Chauhan, Bindi ; Patel, Deepkumar ; Khan, Nashmia ; Kapoor, Ashish ; Kavi, Tapan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c288t-ac21a048664ebc405e69da78d542ab5b2734407e0b0e38acd328ab2a295ea3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Epidemiology/Public Health</topic><topic>Neurology</topic><topic>Public Health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Urvish K</creatorcontrib><creatorcontrib>Malik, Preeti</creatorcontrib><creatorcontrib>Shah, Dhaivat</creatorcontrib><creatorcontrib>Sharma, Ashish</creatorcontrib><creatorcontrib>Bhela, Jatminderpal</creatorcontrib><creatorcontrib>Chauhan, Bindi</creatorcontrib><creatorcontrib>Patel, Deepkumar</creatorcontrib><creatorcontrib>Khan, Nashmia</creatorcontrib><creatorcontrib>Kapoor, Ashish</creatorcontrib><creatorcontrib>Kavi, Tapan</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Urvish K</au><au>Malik, Preeti</au><au>Shah, Dhaivat</au><au>Sharma, Ashish</au><au>Bhela, Jatminderpal</au><au>Chauhan, Bindi</au><au>Patel, Deepkumar</au><au>Khan, Nashmia</au><au>Kapoor, Ashish</au><au>Kavi, Tapan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><date>2020-08-14</date><risdate>2020</risdate><volume>12</volume><issue>8</issue><spage>e9743</spage><epage>e9743</epage><pages>e9743-e9743</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Introduction
The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches.
Methodology
We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student’s t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders.
Results
A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p<0.0001). Opioid abusers with headaches were more likely to be younger (43 years old vs. 50 years old), men (30.17% vs. 24.78%), white (80.83% vs. 73.29%), Medicaid recipients (30.15% vs. 17.03%), and emergency admissions (85.4% vs. 78.51%) as compared to opioid non-abusers with headaches (p<0.0001). Opioid abusers with headaches had higher prevalence and odds of morbidity (4.06% vs. 3.70%; adjusted odds ratio [aOR]: 1.48; 95% CI: 1.39-1.59), severe disability (28.14% vs. 22.43%; aOR: 1.58; 95% CI: 1.53-1.63), and discharge to non-home location (17.13% vs. 18.41%; aOR: 1.35; 95% CI: 1.30-1.40) as compared to non-abusers. US hospitalizations in years 2013-2014 showed the migraine (OR: 1.61; 95% CI: 1.57-1.66), TTH (OR: 1.43; 95% CI: 1.22-1.66), and CH (OR: 1.34; 95% CI: 1.01-1.78) were linked with opioid abuse.
Conclusion
Through this study, we found that the prevalence of migraine, TTH, and CH was higher in opioid abusers than non-abusers. Opioid abusers with primary headache disorders had higher odds of morbidity, severe disability, and discharge to non-home location as compared to non-abusers.</abstract><cop>Palo Alto (CA)</cop><pub>Cureus</pub><pmid>32944458</pmid><doi>10.7759/cureus.9743</doi><oa>free_for_read</oa></addata></record> |
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| title | The Opioid Epidemic and Primary Headache Disorders: A Nationwide Population-Based Study |
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