Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort Study

Fergus, Kirkpatrick B.; Schwab, Marisa E.; Butler, Christi; Cattle, Chloe J; Breyer, Benjamin N.; Copp, Hillary L.

doi:10.1016/j.amepre.2021.12.026

Cited by 4 publications

(6 citation statements)

References 21 publications

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“…In addition to identifying these differences in preoperative SRS domain scores, there were differences observed between the three medication groups in terms of age and sex. This is not surprising as there have been many studies reporting demographic and socioeconomic differences both in opiate use 6,36 and mental health risk. [37][38][39] The complex relationship between all three, substance use, mental health, and demographic/socioeconomic variables, has also been highlighted by previous studies.…”

Section: Clinical Case Seriesmentioning

confidence: 96%

“…[37][38][39] The complex relationship between all three, substance use, mental health, and demographic/socioeconomic variables, has also been highlighted by previous studies. 6,36,38 Even when controlling for age and sex, the medication groups still had a significantly increased likelihood of domain scores below the 25th percentile for Mental Health, Pain, and Function.…”

Section: Clinical Case Seriesmentioning

confidence: 96%

“…A 26% increase in opioid overdose deaths occurred from 2020 to 2021 2 . Research has shown that legitimate opioid use related to a health condition is associated with an increased risk of later developing opioid misuse 3–6 . The period of adolescence into young adulthood has been identified as a high-risk time for opioid misuse 6,7 …”

mentioning

confidence: 99%

“…2 Research has shown that legitimate opioid use related to a health condition is associated with an increased risk of later developing opioid misuse. [3][4][5][6] The period of adolescence into young adulthood has been identified as a high-risk time for opioid misuse. 6 The relationship between opioid dependence or misuse with depression and anxiety has been demonstrated in previous studies.…”

mentioning

confidence: 99%

“…[3][4][5][6] The period of adolescence into young adulthood has been identified as a high-risk time for opioid misuse. 6 The relationship between opioid dependence or misuse with depression and anxiety has been demonstrated in previous studies. [8][9][10][11][12][13][14][15] Research has shown that a diagnosis of a mental health disorder results in an increased risk of utilization of nonmedical opioids and opioid use disorder.…”

mentioning

confidence: 99%

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Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Bastrom

Kelly

Upasani

et al. 2023

Spine

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Study Design. Observational case control Objective. Evaluate the prevalence of opioid use at 2 years after surgical correction of adolescent idiopathic scoliosis (AIS) and association with preoperative mental health. Summary of Background Data. Studies of opiate use have reported that up to 80% of users began their addiction with misuse of prescription opioids. Identifying opioid use and those at risk in the AIS population is critical for optimal outcomes. Methods. A query of a multi-center prospective AIS surgical fusion registry was performed to identify patients of all curve types with responses to Question 11 on the SRS-22 questionnaire at 2 years postoperative. Question 11 asks about pain medication usage for the patient’s back with 5 specific responses; narcotics daily, narcotics weekly or less, non-narcotics daily, non-narcotics weekly/less; or none. Ordinal regression was used to evaluate the association between preoperative SRS-22 Mental Health (MH) domain scores and 2 year postoperative pain medication usage. Results. 2595 patients who underwent surgery from 2002-2019 met inclusion. The average primary curve was 56±12°, average age 14.7±3 years, and 81.5% were female. Forty (1.5%) patients reported utilizing opioids 2 years after surgery and a significant difference in preoperative MH scores was observed. Patients taking daily opioids postoperatively had the lowest median preoperative MH score (3.75), followed by non-narcotic group (4), and no medication (4.2,P<0.001). Three patients reporting opioid use postoperatively reported preoperative usage. The rate of 2 year postoperative medication use based on year of surgery demonstrated a small linear decrease in opioid use over time, with a slight increase in non-opioid daily use. Conclusion. Less than 2% of patients reported taking opioids for back pain 2 years after surgical correction of AIS. A lower Mental Health score prior to surgery may place a patient at increased risk for opioid use 2 years after surgery. An analysis of year of surgery suggests that changes in prescription practices over time may be occurring. Level of Evidence. Level 4

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