Surgeons Play Key Role in Reducing Post-Surgery Opioid Dependency

Opioids are intended to be a short-term treatment for pain following surgery, but many patients who have undergone become dependent.

According to a study presented at the 54th Annual Meeting of the Society of Thoracic Surgeons, 1 in 7 patients who have had lung surgery have become persistent opioid users.

The authors defined new persistent opioid users as patients who had not previously taken opioids, underwent surgery, were prescribed opioids to relieve post-surgical pain, and continued taking opioids after they had recovered from surgery.

The researchers examined data from insurance claims of more than 100 different health plans between 2010 and 2014. The researchers noted that 3026 patients who had received lung resection surgery had not previously taken opioids.

One in 7 of these patients became dependent on opioids after undergoing surgery.

Patients were nearly twice as likely to develop an opioid dependence if they underwent an open surgery with a large incision, rather than a minimally invasive procedure, according to the data. Additionally, 17% of patients who had open lung surgery were likely to become opioid dependent, compared with only 9% of patients who had minimally invasive procedures.

Researchers suggested that health care providers educate patients about the risk of opioid use and offer alternative methods of pain management.

“It is vitally important to discuss pain management with your surgeon and other health care providers prior to surgery,” study author Alexander A. Brescia, MD said in a press release. “Taking opioids for pain following an operation could put patients at risk of becoming dependent or addicted to these medications. Together with their surgeons, patients should develop a plan to appropriately manage their pain while also minimizing their risk of taking these medications for longer than intended after surgery.”

According to the CDC, opioid prescriptions were at an all-time high in 2012, with more than 255 million prescriptions and a rate of 81.3 prescriptions for every 100 people. These rates have declined, but opioid use still remains high in the United States, with 214 million prescriptions dispensed in 2016.

The high number of prescriptions is significant because prescription opioids play a role in 40% of opioid overdose deaths, according to CDC data.

The study authors called on surgeons to be more cautious when prescribing opioids after surgery.

“Surgeons are at the forefront of the opioid crisis as the main prescribers of these medications following surgery,” Dr Brescia said. “Our research attaches data to this epidemic and hopefully provides a clear characterization of the issue and highlights ways to combat the crisis, with important roles for both surgeons and patients.”

Reference

1 in 7 lung surgery patients at risk for opioid dependence [news release]. Michigan Medicine Comprehensive Cancer Center press office. Jan. 30, 2018/ https://www.mcancer.org/news/archive/1-7-lung-surgery-patients-risk-opioid-dependence Accessed Feb. 6, 2018.