January 22, 2018
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Number of opioid refills, duration of use increased risk of opioid misuse

Results published in BMJ showed the number of opioid prescription refills and duration of use among opioid naïve patients were associated with an increase in opioid misuse.

Among 1,015,116 patients who were opioid naïve at the time of surgery, 56% received postoperative opioids. They found 0.6% of patients overall had a code for abuse.

Results showed eventual misuse of opioids was best predicted by the number of post-discharge prescriptions, with the rate of misuse more than doubling among patients who had one refill vs. patients with no refills. Researchers noted the rate of misuse increased by 70.7% before and by 44% after adjusting for covariates.

Results showed an average increase in the rate of misuse of 34.2% for each additional week of opioid use. Researchers found an increase in hazard of 19.9% for each additional week of opioid use after they adjusted for covariates. Benzodiazepines and regimens initiated with hydromorphone and oxycodone had a statistically significant association with opioid misuse after adjusting for covariates, according to results. After controlling for the strongly associated presurgical diagnoses, including bariatric surgery status, tobacco use disorder, other chronic pain and major depressive disorder, researchers noted a greatly attenuated adjusted effect of surgery. – by Casey Tingle

 

Disclosures: The authors report no relevant financial disclosures.