Risk of persistent opioid use a concern for youth after surgery

(HealthDay)—Adolescents and young adults are at risk for persistent opioid use after surgery, and this represents an important pathway to consider in the epidemic of prescription opioid misuse, according to a study published online Dec. 4 in Pediatrics.

Calista M. Harbaugh, M.D., from the University of Michigan in Ann Arbor, and colleagues performed a retrospective cohort study involving opioid-naive patients aged 13 to 21 years who underwent one of 13 operations. As a comparison, a random sample of 3 percent of nonsurgical patients who matched eligibility criteria was included.

The researchers found that 60.5 percent of eligible patients filled a postoperative opioid prescription. In 4.8 percent of patients there was persistent opioid use (2.7 to 15.2 percent across procedures), compared with 0.1 percent in the nonsurgical group. The highest risk of persistent opioid use was seen in association with cholecystectomy and colectomy (adjusted odds ratios, 1.13 and 2.33, respectively). Older age, female sex, previous substance use disorder, chronic pain, and preoperative opioid fill were independent risk factors.

"Persistent opioid use after surgery is a concern among adolescents and young adults and may represent an important pathway to prescription opioid misuse," the authors write. "Identifying safe, evidence-based practices for pain management is a top priority, particularly among at-risk patients."

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