Risk Factors and Prevention Strategies for Postoperative Opioid Abuse

Abstract

Worldwide, 80% of patients who undergo surgery receive opioid analgesics as the fundamental agent for pain relief. However, the irrational use of opioids leads to excessive drug dependence and drug abuse, resulting in an increased mortality rate and huge economic loss. The crisis of opioid overuse remains a great challenge. In this review, we summarize several key factors in opioid abuse, including race, region, income, genetic factors, age and gender, smoking and alcohol abuse, history of chronic pain and analgesic drug abuse, surgery, neuropsychiatric illness, depression and antidepressant use, human factors, national policies, hospital regulations, and health insurance under treatment of pain. Furthermore, we present several prevention strategies, such as perioperative measures, opioid substitutes, treatment of the primary illness, emotional regulation, use of opioid antagonists, efforts of the state, hospitals, doctors and pharmacy benefit managers, gene therapy, and vaccines. Greater understanding and better assessment are required of the risks associated with opioid abuse to ensure the safety and analgesic effects of pain treatment after surgery.

Retracted: Deceptology in cancer and vaccine sciences: Seeds of immune destruction‐mini electric shocks in mitochondria: Neuroplasticity‐electrobiology of response profiles and increased induced diseases in four generations – A hypothesis

“…Major methods that establishment continue to employ on utilizing reductionist approaches to cancer and vaccine projects that created tremendous misunderstanding, misinformation, debates, and controversies and resulted in increased diseases in young and old are listed below: 1–83 ’’…”

Can We Eliminate Opioid Medications for Postoperative Pain Control? A Prospective, Surgeon-Blinded, Randomized Controlled Trial in Knee Arthroscopic Surgery

“…Numerous patient demographics and risk factors have been associated with increased narcotic consumption after surgery. 9,26 Preoperative opioid use, lower socioeconomic status, preoperative pain, medical comorbidities, depression, and a history of substance abuse have all been linked with chronic opioid use after surgery. Specific to knee arthroscopic surgery, patients undergoing meniscal repair, those with a history of smoking, or those taking opioids before surgery have been reported to be more likely to take greater than 19 opioid pills after surgery.…”

Health(care) in the Crisis: Reflections in Science and Society on Opioid Addiction

“…The authors concluded that patients initiated with tramadol, long-acting opioids or doses over 90 morphine milligram equivalents were more likely to continue opioid use [ 28 ] Additionally, multiple studies have characterized the duration of the prescription and high opioid dose as strong predictors of the likelihood of long-term use [ 27 , 28 , 29 , 30 ]. Other risk factors are continued use of other medicines (benzodiazepines, muscle relaxants), history of alcohol, tobacco or drug abuse, lower socioeconomic status and psychiatric disorders [ 28 , 31 , 32 ] which will, unfortunately, most likely increase as a consequence of the ongoing COVID-19 pandemic and the related anxiety and social deprivation. As numbers of opioid overdose deaths continue to grow in the U.S., Centers for Disease Control and Prevention (CDC) discovered that in 63% of cases there is also another drug involved.…”