Integrating Addiction Medicine Into Burn Care: Optimizing Pain Management in Stimulant-Positive Patients.

Abstract

Stimulant use poses significant challenges in burn care, complicating pain management and leading to poorer outcomes, including longer hospital stays, higher complication rates, and increased healthcare costs. This study evaluates burn-related outcomes in stimulant-positive patients, as well as tabulates how frequently addiction medicine consultations are used in burn patients with positive stimulant screens. Patients with positive urine toxicology screens for stimulants, including amphetamines and cocaine, were identified. The primary predictor variable was stimulant use, while primary outcomes included length of hospital stay, burn severity, complications, and overall outcomes of care. Out of 3403 burn patients (34% female, 66% male, with a mean age of 39.2 ± 22.8 years), 572 patients (16.8%) had positive urine toxicology screens for stimulants. Stimulant-positive patients had significantly longer hospital stays compared to stimulant-negative patients (17.7 vs. 10.7 days, P < .001), more severe burns (P = .001), and a higher incidence of complications (15.6% vs. 11.5%, P = .006). Despite these risks, only 12.6% (72 patients) of stimulant-positive burn patients received an addiction medicine consultation during their hospitalization. The use of addiction medicine consultations increased over time, rising from 3 consults in 2015 to 42 in 2023. A multidisciplinary approach that includes addiction medicine can help address both the complexities of pain management and substance use, leading to improved patient outcomes. Early involvement of addiction medicine could enhance pain management and recovery, emphasizing the need for more systematic integration of addiction medicine into burn care protocols.