Study: Long Term Opioid Use Rare After Surgery

Pat Anson, Editor

It’s become a popular belief that many people become addicted to opioid pain medication after surgery. According to a recent national survey, one in ten pain patients believe they became addicted or dependent on opioids after they started taking them for post-operative pain.

But a large new study in Canada found that long term opioid use after surgery is extremely rare, with less than one percent of older adults still taking opioid pain medication a year after major elective surgery.

The study, published in the journal JAMA Surgery, looked at over 39,000 “opioid naïve” patients (no opioid prescriptions in the prior year) over age 65 who had a heart, lung, colon, prostate or hysterectomy surgery from 2003 to 2010.

One year after the surgery, only 168 of the surviving patients were still prescribed opioids – a rate of just 0.4 percent.

“Exposure to opioids is largely unavoidable after major surgery because they are routinely used to treat postoperative pain,” wrote lead author Hance Clarke, MD, Toronto Western Hospital.

In a previous study, Clarke and his colleagues looked at opioid use after major surgery and found that about 3% of patients were still taking opioids after three months. They decided to do this follow-up study to see how many were still being prescribed opioids 180 days, 270 days and 365 days after surgery. They found a steady decline in opioid use throughout the year.

“The estimate of 0.4% of patients continuing to receive opioids at 1 year is consistent with some limited available data,” Clarke wrote. “Our study thus provides reassurance that the individual risk of long-term opioid use in opioid-naive surgical patients is low.”

Earlier this year the American Pain Society (APS) released guidelines for postoperative pain care that encourage the use of non-opioid medications such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentin (Neurotin) and pregabalin (Lyrica).  The APS also said epidural injections could be used for pain relief during some surgeries.

A survey of over 1,200 pain patients by Pain News Network and the International Pain Foundation found that two-thirds of patients believe that non-opioid medication “did not help at all” in the hospital. Another 60 percent said their pain was not adequately controlled in the hospital after a surgery or treatment.