RSNA 2017: Emergency rads on the front lines of opioid crisis

The opioid epidemic continues to make headlines as it takes lives across the country. One radiologists sees how the industry can do more to engage patients in this vulnerable population.

Efren Flores, MD, an emergency radiologist at Massachusetts General Hospital in Boston, led a 12-year study investigating the increasing prevalence of patients with opioid use disorders seen by emergency radiologists.

Flores presented his findings Nov. 30 at RSNA 2017 in Chicago.

“We’ve seen a dramatic increase in the past year of patients coming into the Emergency Department with complications related to substance use disorders,” he said. “The patient population is underserved. By the time we see them, they have more advanced complications because they’re hesitant to ask for help due to social stigmas.”

Flores and colleagues examined 1,031 patients who underwent imaging procedures for substance abuse or misuse between 2005 and 2016. The group was 66 percent male and 78 percent white with a median age of 36 years old.

The participants were imaged 1,673 times, including 779 x-rays, 544 CTs, 292 MRIs and 58 ultrasounds. Results often provided information such as when physicians changed treatments for an individual with lumbar spine infection related to substance abuse.

Approximately 30 percent of patients had a history of opioid prescriptions before a first imaging exam. Mean time from opioid prescription to imaging exam was significantly shorter in women (45 months) than men (51 months).

A total of 121 patients (11.7 percent) died before the study’s conclusion. The mortality rate jumped to 14 percent for patients with positive imaging diagnoses of substance-abuse complications.

Flores encouraged emergency radiologists to engage with patients beyond image readings. He said radiologists could discuss the benefits of sterile needs, needle exchange programs and sterilization procedures.

“Radiology is central to patient care in the emergency department setting,” Flores said. “We need to be actively advocating for these patients and giving them an opportunity to take steps into recovery.”