Susan E Mackie1, R Kathryn McHugh2, Katherine McDermott3, Margaret L Griffin2, John W Winkelman4, Roger D Weiss2. 1. Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115; Massachusetts General Hospital, 1 Bowdoin Square, 9th floor, Boston, MA 02114. Electronic address: semackie@partners.org. 2. Harvard Medical School, 25 Shattuck Street, Boston, MA 02115; McLean Hospital, 115 Mill St., Belmont, MA 02478. 3. McLean Hospital, 115 Mill St., Belmont, MA 02478. 4. Harvard Medical School, 25 Shattuck Street, Boston, MA 02115; Massachusetts General Hospital, 1 Bowdoin Square, 9th floor, Boston, MA 02114.
Abstract
BACKGROUND AND AIMS: Restless legs syndrome (RLS) is a movement disorder associated with adverse health outcomes and decreased quality of life. Small case series suggest that symptoms of RLS occur during opioid withdrawal. However, the prevalence is unknown. METHODS: We conducted an observational study to determine the prevalence of RLS among inpatients patients receiving buprenorphine detoxification from opioids. To assess the specificity of RLS to opioid detoxification, we also evaluated patients receiving detoxification from alcohol as a comparison group. The diagnosis of RLS was established using a validated questionnaire. RESULTS: The sample consisted of 124 adults with primary opioid use disorder and 180 with primary alcohol use disorder. In the total sample, 33.6% met a likely RLS diagnosis: 50.8% of those with opioid use disorder and 21.7% of those with alcohol use disorder (χ2 = 27.96[1,304] p < .001). In the logistic regression analysis controlling for socio-demographic and clinical variables, diagnosis of opioid use disorder was associated with more than twice the likelihood of RLS diagnosis (OR=2.05, 95% CI 1.09-3.88) relative to diagnosis of alcohol use disorder. CONCLUSIONS: Approximately half of patients undergoing inpatient opioid detoxification exhibited the symptoms characteristic of RLS. We believe that these data support the existence of a secondary form of RLS associated with opioid withdrawal.
BACKGROUND AND AIMS: Restless legs syndrome (RLS) is a movement disorder associated with adverse health outcomes and decreased quality of life. Small case series suggest that symptoms of RLS occur during opioid withdrawal. However, the prevalence is unknown. METHODS: We conducted an observational study to determine the prevalence of RLS among inpatients patients receiving buprenorphine detoxification from opioids. To assess the specificity of RLS to opioid detoxification, we also evaluated patients receiving detoxification from alcohol as a comparison group. The diagnosis of RLS was established using a validated questionnaire. RESULTS: The sample consisted of 124 adults with primary opioid use disorder and 180 with primary alcohol use disorder. In the total sample, 33.6% met a likely RLS diagnosis: 50.8% of those with opioid use disorder and 21.7% of those with alcohol use disorder (χ2 = 27.96[1,304] p < .001). In the logistic regression analysis controlling for socio-demographic and clinical variables, diagnosis of opioid use disorder was associated with more than twice the likelihood of RLS diagnosis (OR=2.05, 95% CI 1.09-3.88) relative to diagnosis of alcohol use disorder. CONCLUSIONS: Approximately half of patients undergoing inpatient opioid detoxification exhibited the symptoms characteristic of RLS. We believe that these data support the existence of a secondary form of RLS associated with opioid withdrawal.
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