Non-pain-related factors, including previous use of pain medications, symptoms of depression and perceived risk of addiction, increase the risk of continued use of opioids several months after surgery, according to California researchers.
“Each of these factors was a better predictor of prolonged opioid use than postoperative pain duration or severity,” Ian Carroll, MD, MS, of Stanford University, stated in a press release. “As patients recover from surgery, they face an ongoing choice either to continue taking prescribed opioids and undertake non-opioid pain treatment.”
Carroll and colleagues analyzed 109 patients who underwent a total hip replacement, total knee replacement, thoracotomy, lumpectomy or mastectomy between January 2007 and April 2009 for factors which might influence continued opioid use. Six percent of patients still used their opioid prescriptions 5 months after surgery, according to the abstract.
The results were published in Anesthesia & Analgesia.
Whether prescribed or not, patients who took opioids preoperatively were 73% more likely to continue use of opioids postoperatively. Using the Beck Depression Inventory, Carroll and colleagues also found that opioid use for patients with depression increased by 42% for every 10 points on the scale. Risk of opioid use for patients who rated their perceived risk of addiction on a four point scale increased by 53% for every one point increase on the scale, according to the abstract.
Carroll I, Barelka P, Wang CKM, et al. A pilot cohort study of the determinants of longitudinal opioid use after surgery. Anesth Analg. 2012; Sep:115(3):694-702. doi:10.1213/ANE.0b013e31825c049f.
Disclosure: Carroll has no relevant financial disclosures.