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Michigan OPEN
Michigan OPEN
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Publications (Old)

OPEN examines data, clinical practices and strategies to support better pain management, opioid stewardship, policy, treatment and care.

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.

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

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.

New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults

Brummett CM, Waljee JF, Goesling J, et al. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg. 2017;152(6):e170504. doi:10.1001/jamasurg.2017.0504
  • New persistent opioid use after surgery is common, with approximately 6% of patients who were not on opioids before surgery continuing to use opioids more than 3 months after surgery.
  • New persistent opioid use after surgery is an underappreciated surgical complication that warrants increased attention.