Publications (Old)
OPEN examines data, clinical practices and strategies to support better pain management, opioid stewardship, policy, treatment and care.
Dentistry Pain Management General Publications
Persistent Opioid Use Associated With Dental Opioid Prescriptions Among Publicly and Privately Insured US Patients, 2014 to 2018
Chua KP; Hu HM; Waljee JF; Nalliah RP; Brummett CM; Persistent Opioid Use Associated With Dental Opioid Prescriptions Among Publicly and Privately Insured US Patients, 2014 to 2018. JAMA Network Open. Published online 16 April 2021. DOI: 10.1001/jamanetworkopen.2021.6464- Persistent opioid use (POU) was defined as 1 or more dispensed opioid prescriptions 4 to 90 days after the index date and 1 or more prescriptions 91 to 365 days after the index date. Overall POU was 1.3%, and the risk of POU was higher among publicly insured (2.0%) than privately insured patients (0.9%).
- The initial dental opioid prescriptions were associated with a 1.0–percentage point higher risk of POU among publicly insured patients compared with privately insured patients.
- The results further highlight the importance of avoiding dental opioid prescribing when nonopioids provide effective analgesia, which is the case for most dental procedures.
Association Between Long-term Opioid Use in Family Members and Persistent Opioid Use After Surgery Among Adolescents and Young Adults
Harbaugh CM, Lee JS, Chua KP, et al. Association Between Long-term Opioid Use in Family Members and Persistent Opioid Use After Surgery Among Adolescents and Young Adults. JAMA Surg. 2019;154(4):e185838. doi:10.1001/jamasurg.2018.5838- Persistent opioid use occurred in 4.1% of patients with long-term opioid use in a family member compared with 2.4% of patients without long-term opioid use in a family member.
- Long-term opioid use among family members is associated with persistent opioid use among opioid-naive adolescents and young adults undergoing surgical and dental procedures.
New persistent opioid use among older patients following surgery: A Medicare claims analysis
Santosa KB, Hu HM, Brummett CM, et al. New persistent opioid use among older patients following surgery: A Medicare claims analysis. Surgery. 2020;167(4):732-742. doi:10.1016/j.surg.2019.04.016- Among opioid naïve Medicare patients who underwent major or minor surgery, 9.8% developed new persistent opioid use.
- Modifiable factors were: filled a preoperative opioid, received ≥300 OMEs of opioids in the perioperative period, filled prescriptions for a benzodiazepine, sedative, hypnotic, or anxiolytic within 90 days before surgery.
- High risk prescribing, including filling overlapping opioid prescriptions, having a concurrent benzodiazepine prescription, new receipt of long-acting opioids for acute postsurgical pain, and opioid doses of ≥100 OME, was associated with an increased risk for new persistent opioid use.
Obstetrics Pain Management General Publications
Rates of New Persistent Opioid Use After Vaginal or Cesarean Birth Among US Women
Peahl AF, Dalton VK, Montgomery JR, Lai YL, Hu HM, Waljee JF. Rates of New Persistent Opioid Use After Vaginal or Cesarean Birth Among US Women. JAMA Net Open. 2019;2(7):e197863. Published 2019 Jul 3. doi:10.1001/jamanetworkopen.2019.7863- Rate of new persistent opioid use was 1.7% among women who underwent vaginal delivery
- Rate of new persistent opioid use was 2.2% among women having cesarean birth.
- Modifiable factors, filling an opioid prescription before delivery, and among women underwent vaginal deliveries, receiving a prescription ≥225 OMEs, were associated with increased odds of new persistent use.
- Rates of new persistent use have decreased between 2008 and 2016
Surgery Pain Management General Publications
Provider Characteristics Associated with Outpatient Opioid Prescribing After Surgery
Cron DC, Lee JS, Dupree JM, et al. Provider Characteristics Associated With Outpatient Opioid Prescribing After Surgery. Ann Surg. 2020;271(4):680-685. doi:10.1097/SLA.0000000000003013- Advanced practice providers account for 1-in-5 postoperative opioid prescriptions.
- Postoperative opioid prescriptions written by advanced practice providers are 18% larger than those written by physicians.
Health Care Spending and New Persistent Opioid Use After Surgery
Lee JS, Vu JV, Edelman AL, et al. Health Care Spending and New Persistent Opioid Use After Surgery. Ann Surg. 2020;272(1):99-104. doi:10.1097/SLA.0000000000003399- For patients undergoing major or minor surgery, new persistent use was associated with significantly higher health care spending during the 180 days after surgery.
- Patients with new persistent opioid use continued to have significantly higher monthly health care spending in contrast to patients who develop other common postoperative complications, in which health care spending returns to baseline by 180 days after surgery.
Transitions of Care for Postoperative Opioid Prescribing in Previously Opioid-Naïve Patients in the USA: A Retrospective Review
Klueh MP, Hu HM, Howard RA, et al. Transitions of Care for Postoperative Opioid Prescribing in Previously Opioid-Naïve Patients in the USA: a Retrospective Review. J Gen Intern Med. 2018;33(10):1685-1691.- Among surgical patients who developed new persistent opioid use, surgeons provided the majority of opioid prescriptions during the first three months after surgery.
- By nine to twelve months after surgery, however, the majority of opioid prescriptions were provided by primary care physicians.