Preoperative vs Postoperative Opioid Prescriptions and Prolonged Opioid Refills Among US Youths
Authors' conclusion
In this retrospective study of youths undergoing surgical procedures, of which, many are typically not painful enough to require opioid use, opioid dispensing declined, but approximately 1 in 6 prescriptions were filled before surgery, and 1 in 33 adolescents filled prescriptions 91 to 180 days after surgery, consistent with new persistent opioid use.
Study context
- Population
- Opioid-naive US youths aged 11 to 20 years undergoing 22 inpatient and outpatient surgical procedures, 2015–202046,951 filled an initial prescription
- Participants
- 100,026 participants
- Exposure
- Preoperative vs postoperative initial opioid prescriptions
- Preoperativen = 7,587
- Outcome
- Percentage of initial opioid prescriptions filled up to 14 days prior to vs 7 days after a procedure
Methodological detailsnational claims data
- National claims data
Main finding
As reported in the abstract
Preoperative
16.2%
7587
- Youths filling an initial opioid prescription
- 46 951 (46.9%)
Observational data: associations, not effects.
Secondary outcomes
Opioid quantity dispensed, initial prescription
- Mean quantity dispensed, morphine milligram equivalents (MME)
- 227 (95% CI 225-229)
Second prescription filled · up to 30 days after surgery
- Youths filling a second prescription
- 6467 (13.8%)
- Mean MME of second prescription
- 239 (95% CI 231-246)
Refill 91 to 180 days after surgery (proxy for new persistent opioid use)
- Youths refilling a prescription
- 1216 (3.0%)
Factors associated with new persistent opioid use
- Preoperative prescriptions, increasing age, and procedures not typically associated with severe pain most strongly associated with new persistent opioid use
- Multivariable logistic regression
Original publication
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