Study Finds Increased Risk Of Chronic Opioid Use After Surgery
According to researchers at the Stanford University School of Medicine, a study of health insurance claims revealed that patients who had undergone the most common surgeries were at increased risk of engaging in chronic opioid use. The study was published recently in JAMA Internal Medicine.
In the study, chronic opioid use was defined by 10 or more prescriptions filled, or receipt of 120-day+ supply of an opioid between 3-12 months post surgery.
Knee surgery patients were at the greatest risk, about 5 times more likely than the control group to engage in chronic opioid use. Gall bladder surgery patients were next, at 3.5 times more likely than the controls. There was also an increased risk after cesarean section.
Other risk factors included being male, elderly, and having a history of antidepressant use or drug abuse. Drugs used in the study included fentanyl, hydrocodone, and oxycodone.
Past studies also revealed similar results, but this study was a big different. Researchers used patients who had not received opioid prescriptions for at least a year before surgery.
Health claims filed from 2001-2013 from nearly 642,000 patients aged 18-64 were examined. They were then compared to 18 million non-surgical patients. In all, 11 surgeries were associated with an increased risk of chronic opioid use.
The Foundation for Anesthesia Education and Research and the Anesthesia Quality Institute funded the research through a grant. The study was also supported by Stanford’s Department of Anesthesiology.
The intent here is not to scare people away from surgery, but to remind physicians and surgeons that patients’ opioid use should be closely monitored post-surgery. Also, other means of pain relief should first be utilized whenever possible.
Unfortunately, even when taken as prescribed, opioids are highly addictive, and the longer they are used, the greater the chance for dependency, tolerance, and withdrawal effects upon cessation.
According to the study’s authors:
“In opioid-naive patients, many surgical procedures are associated with an increased risk of chronic opioid use in the postoperative period. A certain subset of patients (eg, men, elderly patients) may be particularly vulnerable.”
~ G. Nathalee Serrels, M.A., Psychology