|Basic InformationTestsLatest News|Opioid Overdoses and Deaths Flooding U.S. HospitalsIncrease in Alcohol Use, High-Risk Drinking in U.S. AdultsAlcohol Use, Abuse on the Rise in U.S.U.S. Opioid Crisis Continues to Worsen'12-Step' Strategy Boosts Success of Teen Drug Abuse ProgramAddiction Drug Underused by Primary Care Docs in U.S.7-Fold Spike Seen in Opioid-Linked Fatal Car CrashesNew Alcohol Screening, Brief Intervention Manual DevelopedOpioid Abuse Down in Younger Americans, But Up Among Older AdultsTreating ADHD May Help Curb Later Drinking, Drug ProblemsNearly 1 in 5 U.S. Adults Has Mental Illness or Drug ProblemCan Fetal Alcohol Damage Be Undone?Hospitalists Have Role to Play in Mitigating Opioid Use DisorderOpioids Second Only to Marijuana in Illicit Drug Abuse RatesEnding U.S. Opioid Abuse Epidemic Will Take Years: ReportMore Research Shows Big Surge in U.S. Opioid Use, AddictionsOpioid Addicts Find It Hard to Avoid FentanylAddicts Try to Avoid Deadly Fentanyl, But Many Tragically FailPot Plus Booze: A Deadly Mix Behind the WheelAs U.S. Heroin Use Reaches 20-Year High, Cost to Society SoarsHeroin Vaccine Blocks Drug High in Tests on MonkeysElite High Schools Breed Higher Risk of Addiction: StudyDid a 1980 Letter Help Spark the U.S. Opioid Crisis?1 in 4 Americans Knows Someone Hooked on Opioids: PollIt's Often Family to the Rescue During Opioid ODsGuidelines Issued on Substance Use Disorder Treatment in NursesDrug-Impaired Driving Continuing to Rise in the United StatesDrugs Now Involved in More Fatal U.S. Crashes Than Alcohol AloneClinician Awareness of Exercise Addiction May Be LackingHigher Illicit Pot Use in States That OK Medical Marijuana: StudyTrump Administration Offers Grants to Fight Opioid CrisisOpioid Abusers at Higher Death Risk When Addiction Specialists Not Part of CareMany Opioid Addictions Surface After Surgery, Study FindsRehab Services Lacking in States Hit Hard by Opioids'Surprise' Designer Drugs Detected in NYC Hair SamplesFamily History May Magnify Your HangoverHigh Prevalence of Alcohol Use Disorders in EczemaTanning's Allure Tied to Other AddictionsSubstance Abuse Is a Treatable Chronic Medical ConditionHeroin Epidemic Expands Its Grip on AmericaSmoking Slows Recovery From Drug AbuseSubstance Abuse Taxes the American WorkplaceReview: Treatment Options for Benzodiazepine DependenceDo Energy Drinks + Booze = More Injuries?7 in 10 U.S. Workplaces Hit by Opioid Abuse: SurveyPot + Booze = Skidding College GradesLonger Addiction Treatment Is Better, Study ConfirmsMany Patients Get Opioid Rx While Receiving BuprenorphineCDC: Fatal Drug Overdoses More Than Doubled Since 1999Drug OD Deaths Have Nearly Tripled Since 1999: CDCLinksBook ReviewsSelf-Help Groups
Many Opioid Addictions Surface After Surgery, Study Finds
by By Alan MozesHealthDay Reporter
Updated: Apr 12th 2017
WEDNESDAY, April 12, 2017 (HealthDay News) -- Some surgery patients prescribed opioids for post-operative pain relief may face a high risk for developing a long-term opioid addiction, new research warns.
The analysis tracked a half-year of opioid use among more than 36,000 surgery patients. None had taken opioids before their surgical procedure.
"We found that 5 to 6 percent of patients not using opioids prior to surgery continued to fill prescriptions for opioids long after what would be considered normal surgical recovery," said study author Dr. Chad Brummett. He is director of the division of pain research at the University of Michigan Medical School.
"Moreover, the rates of new chronic use did not differ between patients having major and minor surgeries, suggesting that patients continue to use these pain medications for something other than simply pain from surgery," he added.
The risk was highest among smokers; patients who had struggled with alcohol and/or drugs in the past; those previously diagnosed with depression or anxiety; and those with a history of chronic pain, the findings showed.
Patients who smoked and those who had a history of alcohol and/or drug abuse faced about a 30 percent higher risk. And that increased risk rose to roughly 50 percent among patients with a history of arthritis, the researcher said.
The outcome is that "pain medication [prescriptions] written for surgery are a major cause of new chronic opioid use for millions of Americans each year," Brummett said.
More than 50 million surgeries are performed in the United States annually, the study authors noted.
In many cases, the pain control drug of choice is an opioid medication such as Vicodin or Oxycontin. Brummett said that it's not uncommon to offer patients about a week's worth of these meds for post-op pain.
But the United States is in the grip of an opioid painkiller epidemic, with more than 10 million people using prescription opioids for non-medical reasons in 2014, according to the U.S. Department of Health and Human Services.
Meanwhile, there has been a quadrupling of prescriptions for opioids since 1999, even though there has been no commensurate rise in reported pain levels among U.S. patients, the agency added.
In the new study, the patients were about 45 years old, on average. About two-thirds were women, three-quarters were white, and all underwent surgery between 2013 and 2014.
Roughly 80 percent underwent minor surgery, such as varicose vein removal or a range of minimally invasive operations. The other 20 percent underwent a major operation, such as a hysterectomy or colectomy.
Just before surgery, patients were given prescriptions for a total of between 30 to 45 opioid tablets.
But following surgery, about 6 percent of both major and minor surgical patients went on to fill an additional three prescriptions, adding up to an average total of roughly 125 pills over a three- to six-month post-op period, according to the report.
In contrast, among a group of men and women who didn't have surgery and hadn't taken an opioid medication in the prior year, less than half of 1 percent engaged in a similar pattern of long-term opioid abuse.
The findings were published online April 12 in JAMA Surgery.
Brummett acknowledged that pain control is important. And "opioids are still very good medications for treating acute pain after surgery or injury," he added.
"However, in the days or weeks after surgery, patients should wean off of opioids even if they continue to have some pain," he said. "If their pain becomes chronic, they should seek additional care and consider other medications and alternatives to opioids."
One recent study showed that opioid dependence can take hold in as little as five days.
"Clinicians should be cautious about prescribing and consider the potential risks of opioids after surgery," Brummett said. One idea: screening patients, by means of questionnaires, for histories of "pain, mood and function."
Anita Gupta, an international affairs fellow with the Woodrow Wilson School at Princeton University, said the problem calls for much more patient-doctor face time.
"We should have been screening years ago. All patients are not the same," Gupta said.
"Different patients require different treatments," she explained. "Cookie-cutter algorithms and check-boxes are not proper ways to treat all patients who have a broad range of surgeries."
Gupta agreed that "until we find alternatives, opioids will remain a cornerstone of pain treatment. But surgical patients are highly complex. And effective and safe pain management requires making time for patient-centric care, so when we prescribe opioids we do it safely and responsibly."
Visit the U.S. Department of Health and Human Services for more on opioid abuse.
This article: Copyright © 2017 HealthDay. All rights reserved.