{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:13:44Z","timestamp":1788257624353,"version":"build-2803163510"},"reference-count":23,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100015339","name":"ACCP Foundation","doi-asserted-by":"publisher","award":["Futures Grant"],"award-info":[{"award-number":["Futures Grant"]}],"id":[{"id":"10.13039\/100015339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with substance use disorders (SUD) are at an increased risk of admission to intensive care units (ICUs) and the relationship between SUD and commonly used sedative and analgesic medications remains understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to describe associations between substance use disorder (SUD) and medication dose requirements in patients with critical illness requiring invasive mechanical ventilation (IMV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a single center, retrospective study of adult patients admitted to an ICU between January 1, 2017, to October 31, 2022 who were initiated on IMV within 48 hours. The primary outcome was median total daily dose of each sedative and analgesic medication received, grouped as follows: parenteral opioids, benzodiazepines, propofol, and dexmedetomidine. Multivariable median regression was used to determine associations between SUD and median daily dose after adjustment for demographic and clinical covariables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 1290 included patients, 358 (27.8%) had a documented SUD present on admission. In unadjusted analyses, patients with SUD received higher median daily doses of parenteral opioids (197.5 MME [IQR 61.9-344.3] vs 162.2 MME [IQR 60.3-324.6]) and propofol (26\u2009640 \u00b5g\/kg [IQR 11\u2009659-43\u2009518] vs 23\u2009248 \u00b5g\/kg [IQR 10\u2009510-38\u2009870). No differences in median daily dose were noted for parenteral benzodiazepines or dexmedetomidine. In adjusted analyses, associations between SUD and median daily dose of parenteral opioids (\u03b2, 18.1 MME; 95% CI, \u221213.6 to 49.4) or propofol (\u03b2, 1699.9 \u00b5g\/kg; 95% CI, \u22122477.1 to 5882.8) were no longer present.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and relevance:<\/jats:title>\n                    <jats:p>Results of unadjusted analyses aligned with prior studies reporting increased dose requirements of sedation and analgesia in patients with SUD; however, associations were diminished after adjustment for clinical and demographic covariables. Our results suggest the presence of SUD alone may not necessitate empirically higher medication doses in patients with SUD receiving IMV during critical illness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280251383159","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T10:34:59Z","timestamp":1765362899000},"page":"754-763","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Prior Substance Use and Sedation and Analgesia Requirements Among Mechanically Ventilated Adults With Critical Illness"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9128-6291","authenticated-orcid":false,"given":"Megan E.","family":"Feeney","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Boston Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7161-5254","authenticated-orcid":false,"given":"Nicholas A.","family":"Bosch","sequence":"additional","affiliation":[{"name":"The Pulmonary Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100052"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12060782"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000808160.03212.ae"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201701-022OC"},{"key":"e_1_3_2_6_2","unstructured":"SCCM Critical Care Statistics. Society of critical care medicine (SCCM). Accessed August 23 2022. https:\/\/sccm.org\/Communications\/Critical-Care-Statistics"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.06.032"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-7-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200201000-00020"},{"key":"e_1_3_2_11_2","unstructured":"Weiss AJ Barrett ML Heslin KC Stocks C. Appendix A.1 List of ICD-9-CM diagnosis codes and descriptions (inclusion and exclusion criteria) for emergency department visits for substance use disorders (SUDs) December 2016. Accessed August 23 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK409512\/table\/sb216.t5\/"},{"key":"e_1_3_2_12_2","unstructured":"World Health Organization. ICD-10: international statistical classification of diseases and related health problems. 10th Revision. World Health Organization; 2004. 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