Trends in Opioid Prescribing and New Persistent Opioid Use After Surgery in the United States
Authors' conclusion
Both opioid prescription size after surgery and new persistent opioid use decreased over the last decade, suggesting that opioid stewardship practices had favorable effects on the risk of long-term opioid use.
Study context
- Population
- Opioid-naive privately insured adults undergoing 17 common surgical procedures, US, 2013–2021 (Health Care Cost Institute (HCCI) claims)opioid-naive
- Participants
- 989,354 participants
- Exposure
- Trends 2013–2021
- Outcome
- Initial opioid prescription size (OME) and new persistent opioid use
Methodological detailsmulti-payer claims data, mixed effects logistic regression
- Multi-payer claims data
- Mixed effects logistic regression
Main finding
As reported in the abstract
New persistent opioid use (adjusted incidence)
- Adjusted initial opioid prescription size decreased from 282 mg OME to 164 mg OME; reduction
- 118 mg OME (95% CI 116-120)
Observational data: associations, not effects.
Further findings
Predictors of new persistent opioid use: preoperative nonopioid controlled substances fills
| aOR (95% CI) | ||
|---|---|---|
| 31-365 days | 1.78 (1.70–1.86) | |
| 0-30 days | 2.71 (2.59–2.84) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Predictors of new persistent opioid use: orthopedic procedures
| aOR (95% CI) | ||
|---|---|---|
| Total knee arthroplasty | 3.43 (3.15–3.72) | |
| Shoulder arthroscopy | 2.39 (2.24–2.56) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Predictors of new persistent opioid use: initial opioid prescription size
- For every 30 OME increase in initial opioid prescription size, new persistent opioid use increased by
- 3.1%
Original publication
Trends in Opioid Prescribing and New Persistent Opioid Use After Surgery in the United States. Ann Surg. Published 1 August 2024. doi:10.
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