Importance of Drug User Detection

March 25, 2023 updated by: Wafaa Sadek Tolba, Assiut University

Medico Legal Importance of Drug Abuse Detection Before Emergency Operation

  1. Identify the illicit drugs (morphine, cannabinoids, benzodiazepines, barbiturates, tramadol, cocaine, amphetamine, alcohol, synthetic cannabinoids).
  2. Identify illicit drug users in patients who admitted in Assiut University Hospitals undergoing emergency operation and their percent among all patients admitted for emergency operation, for proper selection of anaesthetic agents and proper care before, during and after operations.
  3. Compare between addict and non addict in using suitable anaesthetic agents and doses - period of anaesthesia- period of recovery- complications.
  4. Compare between addict and non addict patients in :( vital signs before, during and after operation by using anaesthetic chart).
  5. Identify the importance of using drug abuse detection as a routine lab work before urgent operations.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Drug addiction has become a more common problem worldwide. In many countries drug abuse is rapidly increasing among young generations .By taking routine preoperative history, it has been noticed that there is a high percentage of patients who were addicted to different types of drugs. Drug addiction remarkably increases morbidity and mortality among patients. Addiction could be defined as a chronic disorder characterized by the compulsive use of a substance, resulting in physical, psychological or social harm to the user and continued use despite that harm .

Substances that could be abused are so many: alcohol, sedative and hypnotics, opioids, cocaine and amphetamines, cannabis, hallucinogens and nicotine. They can be classified as socially acceptable drug (e.g., alcohol, tobacco), a medically prescribed drug (e.g., diazepam), and illegal substance (e.g., cocaine) .

Both acute intoxication and chronic abuse of these substances present challenges for anesthetic management during and after an operation .Whereas some procedures may be delayed while the issue is addressed, others are urgent or emergent and the surgeon and anesthesiologist must be able to deal with the physiologic changes that may occur in these patients.

So, it is important to understand the situations of drug users, such as the category of drugs used, the dosage, the duration of drug use, their history of detoxification or abstention, and especially their current abuse of drugs. Pain threshold in addicts is lower than ordinary people who are not addict to opium due to several reasons including change in function, sensitivity reduction, or decrease in opioid's receptors.

Nevertheless, they are more resistant against narcotics and analgesic drugs. With little information about the history of drug abuse, a quick screening for recent use of drugs is important for both medical staff and patients. The immune colloidal gold (ICG) technique is a well-established technique and is commonly used for screening for drug abuse .

Awareness of the drug's pharmacodynamics, pharmacokinetics and interaction with anesthetics medication is crucial to the proper management of illicit drug users during the perioperative period. Moreover, it is common for illicit drug users to have infection with human immune-deficiency virus (HIV), hepatic C virus (HCV), syphilis or other sexually transmitted disease (STD), which may put medical staff in danger. Incidences of intraoperative and postoperative complications are increased in illicit drug users such as pulmonary infection and coagulation disorders .

Death of drug abusers during anaesthesia and intra operative may occur due to severe cardiovascular cocaine toxicity if general stabilization and hemodynamic control not achieved .

The preventable perioperative complications are evaluated to improve the safety of health care, including also the medical-law point of view .

On the other side, research was done in 2016 at Johans Hopkins found that the average of 250.000 people die in US because of medical errors each year. Updating for this study in 2020 found that the serious medical errors occur most frequently in ICU, emergency departments and operation rooms. Many lawsuits are filled each year against doctors.

For these reasons and more it is important, to the patients and medical staff, to make preoperative drug abuse analysis as a mandatory before emergency surgeries to achieve optimal management during and after operations.

Study Type

Observational

Enrollment (Anticipated)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Two hundred patients who undergoing emergency operation of both sexes, in age group more than 18 years will be included in the study.

Description

Inclusion Criteria:

  • Emergency operations.
  • Age group more than 18 years.

Exclusion Criteria:

  • -Age group less than 18 years.
  • Patients refuse to be included in the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
By using an anaesthetic record sheat
Time Frame: basline

which will include

  • physiological parameter as:
  • age (years)
  • weight (kg)
  • blood pressure(mmHg)
  • heart rate(beat /min)
  • respiratory rate(breath/ min)
basline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Study Director: Doaa Mohamed Almaz, lecturer, Supervision
  • Study Director: Shimaa Abass Hassan, Lecturer, Supervision

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

May 1, 2023

Primary Completion (Anticipated)

May 1, 2024

Study Completion (Anticipated)

December 31, 2024

Study Registration Dates

First Submitted

February 3, 2023

First Submitted That Met QC Criteria

March 25, 2023

First Posted (Actual)

April 7, 2023

Study Record Updates

Last Update Posted (Actual)

April 7, 2023

Last Update Submitted That Met QC Criteria

March 25, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Drug users detection

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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