Risk of Prolonged Opioid Use Among Opioid-Naïve Patients Following Common Hand Surgery Procedures

Johnson, Shepard P.; Chung, Kevin C.; Zhong, Lin; Shauver, Melissa J.; Engelsbe, Michael J.; Brummett, Chad M.; Waljee, Jennifer F.

doi:10.1016/j.jhsa.2016.07.113

Cited by 305 publications

(322 citation statements)

References 39 publications

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“…6,10 Specifically, 76% of patients undergoing CTR surgery have filled at least one prescription for opioid analgesics and 14% have filled a prescription beyond 90 days postoperatively. 4 With a recent national focus on the increasing abuse of prescription opioids in the United States, the use and effectiveness of pre-operative opioid counseling has come under investigation. As this issue continues to garner attention from the medical community, more physicians have begun implementing opioid counseling prior to surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Between the years 1999-2010, rates of opioid sales, deaths, and treatment admission have each more than tripled. 1 In the same period of time, overdose deaths from pharmaceutical opioids represented the highest relative increase of overdose death rates among all drug types in the United States, with a nearly 4-fold increase.…”

Section: Introductionmentioning

confidence: 99%

“…3 Many common elective and trauma-related orthopedic procedures have been identified as potentially resulting in prolonged opioid use, including CTR surgery, for which 76% of patients filled at least one prescription for opioid analgesics and 14% filled a prescription beyond 90 days postoperatively. 4 Despite the already high rate of opioid use following common orthopedic surgeries, opioid prescribing for orthopedic surgeries continues to increase and inadvertent over-prescribing is a common phenomenon. [5][6] Various methods have been explored to decrease the misuse and abuse of prescription opioids in the past decade.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Prospective Randomized Study Analyzing Preoperative Opioid Counseling in Pain Management After Carpal Tunnel Release Surgery

Alter

Ilyas

2017

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Prospective Randomized Study Analyzing Preoperative Opioid Counseling in Pain Management After Carpal Tunnel Release Surgery

Alter

Ilyas

2017

The Journal of Hand Surgery

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“…When examining the surgical population as a whole, including patients taking opioids prior to surgery, postoperative chronic opioid use ranges from 9.2 to 13%. 58,59 In the context of the current opioid crisis, measures to decrease the overall prevalence of chronic opioid use after surgery will decrease opioid-related adverse events including opioid misuse, abuse, addiction, diversion, respiratory depression and overdose.…”

Section: Persistent or Chronic Opioid Use After Surgerymentioning

confidence: 99%

Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic

Hah

Bateman

Ratliff³

et al. 2017

Anesthesia &Amp; Analgesia

556

221

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Physicians, policymakers, and researchers are increasingly focused on finding ways to decrease opioid use and overdose in the United States both of which have sharply increased over the past decade. While many efforts are focused on the management of chronic pain, the use of opioids in surgical patients presents a particularly challenging problem requiring clinicians to balance two competing interests: managing acute pain in the immediate postoperative period and minimizing the risks of persistent opioid use following the surgery. Finding ways to minimize this risk is particularly salient in light of a growing literature suggesting that post-surgical patients are at increased risk for chronic opioid use. The perioperative care team, including surgeons and anesthesiologists, is poised to develop clinical and systems-based interventions aimed at providing pain relief in the immediate postoperative period while also reducing the risks of opioid use longer term. In this paper, we discuss the consequences of chronic opioid use following surgery, and present an analysis of the extent to which surgery has been associated with chronic opioid use. We follow with a discussion of the risk factors that are associated with chronic opioid use after surgery, and proceed with an analysis of the extent to which opioid sparing perioperative interventions (e.g., nerve blockade) have been shown to reduce the risk of chronic opioid use following surgery. We then conclude with a discussion of future research directions.

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“…A study of elective hand surgery patients showed that 13 percent were still taking opioids 90 days after surgery. 23 Another study found that 3.1 percent were still taking opioids at 90 days after major surgery, 24 although the follow-up to 1 year demonstrated that the risk for an opioid-naive patient older than 65 years to be on a persistent opioid is low at 0.4 percent. 25 Other studies have found that total knee arthroplasty patients have a 1.4 percent chance of still taking opioids 1 year after surgery (odds ratio of 5:1 compared with nonoperated controls).…”

Section: Opioid Risk and Surgerymentioning

confidence: 99%

Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

Demsey

Carr

Clarke

et al. 2017

Plastic &Amp; Reconstructive Surgery

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Summary Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder. This review gives an update of the current state of the opioid crisis, explains how current surgeons prescribing practices are contributing to it, and gives recommendations on how to use opioid medication safely in the perioperative period.

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Risk of Prolonged Opioid Use Among Opioid-Naïve Patients Following Common Hand Surgery Procedures

Cited by 305 publications

References 39 publications

A Prospective Randomized Study Analyzing Preoperative Opioid Counseling in Pain Management After Carpal Tunnel Release Surgery

A Prospective Randomized Study Analyzing Preoperative Opioid Counseling in Pain Management After Carpal Tunnel Release Surgery

Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic

Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

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