Physicians are prescribing more opioid painkillers than ever to patients undergoing common outpatient surgeries, according to research.
The research was published online in The Journal of the American Medical Association. The research is from the Department of Anesthesiology and Critical Care at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
Opioid abuse and addiction is a growing concern in the United States, with the National Institute on Drug Abuse estimating that about 2.1 million Americans suffer from substance use disorders related to prescription opioid pain relievers and an estimated 467,000 Americans are addicted to heroin, with increasing recognition of the strong relationship between opioid use and heroin abuse.
The study, which included researchers from the University of Toronto, analyzed insurance claims from 2004 through 2012 for 155,297 adults undergoing four common outpatient surgeries:
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carpal tunnel release;
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laparoscopic cholecystectomy;
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knee arthroscopy;
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inguinal hernia repair.
In an analysis of patients who had not received an opioid prescription in the six months preceding surgery, the researchers observed that four out of every five patients in the study filled a prescription for an opioid pain medication within seven days after surgery. The percentage of patients who obtained those drugs increased from 2004 to 2012 for all four surgical procedures.
Most notably, the amount of opioid medication dispensed to patients after surgery also increased markedly between 2004 and 2012 for all procedures studied. Among patients undergoing knee arthroscopy, for example, the investigators estimated a greater than 18% increase in the average total amount of opioid dispensed, driven by a change in the average daily dose.
“These data show us a concerning trend,” said the study’s senior author, Mark Neuman, MD, MSc, an assistant professor of anesthesiology and critical care and director of the Penn Center for Perioperative Outcomes Research and Transformation. “The growth we observe over time in opioid prescribing after surgery occurs against the backdrop of a major public health crisis of prescription opioid abuse. Additional work is needed to understand how postoperative opioid prescribing patterns might play into this epidemic, and to define better strategies for treating postoperative pain safely and effectively in the future.” (To access the abstract, go to bit.ly/1R9gLkq. For more information on this topic, see this published article: “American Pain Society publishes guideline for post-surgical pain management,” Same-Day Surgery, April 2016, at bit.ly/1XNBWwi.)
