New persistent opioid use following surgery among opioid-naïve patients in the USA: a systematic review and meta-analysis of observational studies
Authors' conclusion
This large meta-analysis indicates that NPOU is a common but highly variable outcome among opioid-naive surgical patients in the USA who are prescribed opioids for acute pain.
Study context
- Population
- Opioid-naïve adult patients newly prescribed opioids for postsurgical pain in the US
- Participants
- 6,507,173 patients · 43 observational studies
- Outcome
- Pooled incidence of new persistent opioid use (NPOU) after surgery
Methodological detailsrandom-effects models, meta-regression, subgroup analyses, Study quality (Newcastle-Ottawa Scale): 8 (18.60%) low, 31 (72.09%) moderate, 4 (9.30%) high, PubMed and Embase searched March 1, 2024 (studies published January 1, 2013 to March 1, 2024)
- Random-effects models
- Meta-regression
- Subgroup analyses
- Study quality (Newcastle-Ottawa Scale): 8 (18.60%) low, 31 (72.09%) moderate, 4 (9.30%) high
- PubMed and Embase searched March 1, 2024 (studies published January 1, 2013 to March 1, 2024)
Pooled result
As reported in the abstract
Pooled incidence of NPOU
Pooled incidence of new persistent opioid use (NPOU)
7.15%
95% CI 6.02 to 8.38
95% prediction interval
1.34% to 17.02%
Further pooled results
NPOU by definition (subgroup)
P < 0.0001
NPOU by surgery type, payer coverage, subsequent analgesia/surgery (subgroup)
- No significant difference by surgery type
- P = 0.4912
- No significant difference by payer coverage
- P = 0.0697
- No significant difference by subsequent analgesia/surgery
- P = 0.6335
Meta-regression on patient/study attributes
- Pooled estimate not significantly associated with study sample size, racial distribution, proportion of male patients, or mean age
Original publication
New persistent opioid use following surgery among opioid-naïve patients in the USA: a systematic review and meta-analysis of observational studies. Reg Anesth Pain Med. Published 26 June 2026. doi:10.
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