Prevalence of Recreational Substance Use in Patients with Seizures at a Tertiary Care Hospital in Mississippi
Abstract number :
2.356
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1825818
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Parul Goyal, MD - Baylor College of Medicine; Prince Sethi, MD - University of Kansas Medical Center; Zachary Goodwin, MD - University of Mississippi Medical Center; Prashant Natteru, MD - University of Mississippi Medical Center; Sameer Sharma, MD - University of Mississippi Medical Center
Rationale: Seizure is a common neurological entity and continues to be a significant burden on the healthcare system as well as quality of life for patient and caregivers. Recreational substance use (RSU) has been associated with seizure especially with use of stimulants, opioids, and benzodiazepines.1 Wolfe et al found higher odds of seizure with RSU in the multi-centric Euro-DEN Plus network across Europe.2 There is limited knowledge on prevalence of seizures in patients with concomitant RSU in U.S. In addition, RSU is an evolving epidemic in the United States. Thus, we aimed to investigate the prevalence of concomitant RSU in patients with seizures at a University based tertiary healthcare system.
Methods: We conducted a retrospective observational study from 01/01/2013 to 02/28/2021. Data from patient cohort explorer (a de-identified database) at University of Mississippi Medical Center was used to select patients with seizure and a positive drug test (either urine or serum). We included amphetamines, cocaine, opioids, cannabinoids, barbiturates, benzodiazepines, and phencyclidine in drug test. The prevalence of RSU for individual substance was reported as percentage of number of encounters.
Results: There were 226,613 encounters with seizure(s) for a total of 40,459 subjects. Of the total, 5787 (2.5%) encounters with 4,342 subjects concomitantly tested positive for RSU. Mean age was 40.1 (±16.9) years, 58.4% were males, 59.1% were African Americans, 38.3% were Caucasians. Gender and race of subjects with concomitant RSU for individual drug class is listed in Table 1 for all age groups and in Table 2 for older than 16 years.
Conclusions: Overall, the most common concomitantly positively tested RSU during seizure encounters was cannabinoid (40.7%) followed by benzodiazepine (38.7%), amphetamines (16.9%), and cocaine (13.2%). There was higher proportion of males’ encounters with concomitant seizure and RSU regardless of type of drug class. Amphetamine use was more common in Caucasians, while the remaining studied RSU were more common in African Americans. Similar trends were seen in subgroup of subjects older than 16 years. The study is limited due to its retrospective nature and database being limited to a single center despite being the only University based tertiary healthcare system in the state of Mississippi. Some subjects may have been tested for benzodiazepines after therapeutic administration of the same for seizure control, falsely increasing its positivity rate. Despite these limitations, this study adds valuable information towards prevalence and understanding of RSU in patients presenting with seizures. Further larger nationwide studies are required to elucidate regional burden and impact of RSU on seizures.
References:
1.Alldredge BK, Lowenstein DH, Simon RP. Seizures associated with recreational drug abuse. Neurology. 1989;39(8):1037-1039
2.Wolfe CE, Wood DM, Dines A, et al. Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set. Neurotoxicology. 2019;73:183-187
Funding: Please list any funding that was received in support of this abstract.: None.
Epidemiology