Patients who haven't filled a prescription in over a year were shown to have a higher risk of chronic opioid use after certain surgical procedures, and some of those patients are more at-risk than others, according to a study in JAMA Internal Medicine.
Researchers examined 11 surgical procedures as part of the study: total knee replacement, total hip replacement, laparoscopic gall bladder removal, open gall bladder removal, laparoscopic appendectomy, open appendectomy, cesarean delivery, functional endoscopic sinus surgery, cataract surgery, transurethral prostate resection and simple mastectomy.
They analyzed health claims data for more than 18 million opioid-naïve patients who underwent those procedures and defined chronic opioid use as filling 10 or more prescriptions within the first year after surgery, excluding the first 90 days post-surgery.
Just four (cataract surgery, laparoscopic appendectomy, sinus surgery and prostate surgery) of the 11 studied surgeries were not associated with increased risk for chronic opioid abuse.
Of the seven procedures associated with increased risk, some of the highest risk was associated with knee replacement, open gall bladder surgery, hip replacement and simple mastectomy.
Male patients, patients over 50 and patients with a history of drug abuse, alcohol abuse and depression were most at-risk, researchers also found.
"Our results should not be taken as advocating that patients forgo surgery out of concerns for chronic opioid use," the authors concluded. "Rather, our results suggest that primary care clinicians and surgeons should monitor opioid use closely in the postsurgical period."