{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:55:47Z","timestamp":1790866547025,"version":"4.1.0"},"reference-count":16,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate the effect of substance use on sedation requirements in critically ill patients to optimize dosing in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multicenter, retrospective, observational, institutional review board\u2013approved, cohort study. Included individuals were aged 18 years and older, required mechanical ventilation for more than 24 hours, and had a history of substance use in the intervention group, defined as documentation of using 1 or more substances within the past year. The primary outcome was the maximum number of concurrent continuous analgesic and sedative infusions required during intubation and mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The primary outcome, maximum number of concurrent continuous analgesic and sedative infusions, was significantly higher when comparing subjects with substance use to those without substance use (3 vs 2 infusions;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Significantly higher doses of analgesia and sedation were also required in the substance use group, including fentanyl (150 vs 100 mcg\/hr;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.024), dexmedetomidine (1.2 vs 1.0 mcg\/kg\/hr;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.040), and benzodiazepines measured in lorazepam equivalents (3 vs 1.5 mg\/hr;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In mechanically ventilated subjects, a statistically significantly higher number of concurrent continuous analgesic and sedative infusions were used in the substance use group, with larger doses required to sedate subjects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.9740\/mhc.2026.10.223","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:07:40Z","timestamp":1790863660000},"page":"223-228","source":"Crossref","is-referenced-by-count":0,"title":["Effects of substance use on sedation requirements in critically ill patients"],"prefix":"10.9740","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8545-7418","authenticated-orcid":true,"given":"Brittany R.","family":"Weger","sequence":"first","affiliation":[{"name":"(Corresponding author) Critical Care Pharmacist, Ascension St. Vincent\u2019s Riverside 1 Shircliff Way, Jacksonville, Forida, brittanyweger9@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6927-227X","authenticated-orcid":true,"given":"Lindsey","family":"Gignac","sequence":"additional","affiliation":[{"name":"Critical Care Pharmacist, Ascension St. Vincent\u2019s Riverside 1 Shircliff Way, Jacksonville, Forida, lindsey.gignac@ascension.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3571-5017","authenticated-orcid":true,"given":"Shannon M.","family":"Reneau","sequence":"additional","affiliation":[{"name":"Critical Care Pharmacist, Ascension St. Vincent\u2019s Riverside 1 Shircliff Way, Jacksonville, Forida, shannon.carabetta@ascension.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5958-2380","authenticated-orcid":true,"given":"Alyssa","family":"Booth","sequence":"additional","affiliation":[{"name":"Infectious Disease Pharmacist, Ascension St. Vincent\u2019s Riverside 1 Shircliff Way, Jacksonville, Forida, alyssa.booth@ascension.org"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4719","reference":[{"key":"i2168-9709-16-5-223-b01","article-title":"Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration","year":"(2023)","unstructured":"Substance Abuse and Mental Health Services Administration. 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Association between prior substance use and sedation and analgesia requirements among mechanically ventilated adults with critical illness. Ann Pharmacother. Epub 2025 Dec 10. DOI: 10.1177\/10600280251383159"},{"issue":"2","key":"i2168-9709-16-5-223-b13","series-title":"Anesthesiology","first-page":"286","article-title":"A double-blind, randomized comparison of I.V. lorazepam versus midazolam for sedation of ICU patients via a pharmacologic model","volume":"95","author":"Barr","year":"2001","unstructured":"Barr J,\nZomorodi K,\nBertaccini EJ,\nShafer SL,\nGeller E. A double-blind, randomized comparison of I.V. lorazepam versus midazolam for sedation of ICU patients via a pharmacologic model. Anesthesiology. 2001;95(2):286-98. 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