Patterns of opioid use in sickle cell disease

Jin Han, Santosh L. Saraf, Xu Zhang, Michel Gowhari, Robert E. Molokie, Joharah Hassan, Chaher Alhandalous, Shivi Jain, Jewel Younge, Taimur Abbasi, Roberto F. Machado, Victor R. Gordeuk

Research output: Contribution to journalArticle

15 Scopus citations


Pain, the hallmark complication of sickle cell disease (SCD), is largely managed with opioid analgesics in the United States, but comprehensive data regarding the long-term use of opioids in this patient population is lacking. The pain medication prescription records from a cohort of 203 SCD patients were analyzed. Twenty-five percent were not prescribed opioid medications while 47% took only short-acting opioids, 1% took only long-acting opioids, and 27% took a combination of short-acting and long-acting opioids. The median (interquartile range) daily opioid dose was 6.1 mg (1.7–26.3 mg) of oral morphine equivalents, which is lower than the published opioid use among patients with other pain syndromes. The dose of opioids correlated with the number of admissions due to vaso-occlusive crisis (VOC) (r = 0.53, P < 0.001). When the patients were grouped into quartiles based on daily dose opioid use, a logistic regression model showed that history of avascular necrosis (AVN) (OR: 2.87, 95% CI: 1.37–6.02, P = 0.005), 25-OHD levels (OR: 0.59, 95% CI: 0.38–0.93, P = 0.024) and total bilirubin concentration (OR: 0.64, 95% CI: 0.42–0.99, P = 0.043) were independently associated with opioid use quartiles. In conclusion, doses and types of opioid medications used by adult SCD patients vary widely. Our findings implicate AVN and lower vitamin D levels as factors associated with higher opioid use. They also suggest an association of higher bilirubin levels, possibly suggesting higher hemolytic rate, with lower opioid use. Am. J. Hematol. 91:1102–1106, 2016.

Original languageEnglish (US)
Pages (from-to)1102-1106
Number of pages5
JournalAmerican Journal of Hematology
Issue number11
StatePublished - Nov 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

Fingerprint Dive into the research topics of 'Patterns of opioid use in sickle cell disease'. Together they form a unique fingerprint.

  • Cite this

    Han, J., Saraf, S. L., Zhang, X., Gowhari, M., Molokie, R. E., Hassan, J., Alhandalous, C., Jain, S., Younge, J., Abbasi, T., Machado, R. F., & Gordeuk, V. R. (2016). Patterns of opioid use in sickle cell disease. American Journal of Hematology, 91(11), 1102-1106.