Low Risk of Developing Opioid Addiction Following Major Surgery

Researchers at Toronto Western Hospital (TWH; Canada), St. Michael’s Hospital (Toronto, Canada), and other institutions conducted an analysis of anonymized administrative information on outpatient prescriptions dispensed to residents of Ontario (Canada) 65 years or older. The study group included those 66 years or older, opioid naïve, and who underwent specific major elective surgeries, such as coronary artery bypass graft surgery (CABG), lung resection, colon resection surgery; radical prostatectomy, and hysterectomy between 2003 and 2010.

The authors measured the time to opioid cessation for any individual receiving an opioid prescription within 90 days after surgery, with the date of cessation defined by absence of any opioid prescription within the preceding 90 days. In all, of 39,140 opioid-naive patients, 53% received one or more opioid prescriptions within 90 days after discharge. By one year after surgery, only 0.4% of the surviving patients continued to receive ongoing opioid prescriptions. The highest risk of long-term persistent opioid use occurred after lung resection procedures. The study was published on August 10, 2016, in JAMA Surgery.

“Exposure to opioids is largely unavoidable after major surgery because they are routinely used to treat postoperative pain. Nonetheless, continued long-term opioid use has negative health consequences, including opioid dependence,” concluded lead author Hance Clarke, MD, PhD, of TWH, and colleagues. “Our study provides reassurance that the individual risk of long-term opioid use in opioid-naive surgical patients is low. Conversely, the large volume of surgeries performed annually means that the population burden of long-term postoperative opioid use remains significant.”

Prescriptions of opioid medications for chronic pain have increased dramatically over the years, a trend that has been accompanied by greatly increased levels of overdose, abuse, addiction, and diversion.

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Toronto Western Hospital
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