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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.

Pediatrics Pain Management General Publications

Persistent Opioid Use Among Pediatric Patients After Surgery

Harbaugh CM, Lee JS, Hu HM, et al. Persistent Opioid Use Among Pediatric Patients After Surgery. Pediatrics. 2018;141(1):e20172439. doi:10.1542/peds.2017-2439
  • Rates of new persistent opioid use among pediatric patients are comparable to those for adults, with 4.8% of patients refilling opioid prescriptions between 3 and 6 months after surgery.
  • Cholecystectomy (15.2%) and Colectomy (7.3%) were associated with the highest risk of persistent opioid use.  
  • Patients with persistent opioid use filled additional prescriptions with an average of 200 to 300 OMEs up to 6 months 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.

Preoperative Opioid Use and Readmissions Following Surgery

Tang R, Santosa KB, Vu JV, et al. Preoperative Opioid Use and Readmissions Following Surgery [published online ahead of print, 2020 Mar 13]. Ann Surg. 2020;10.1097/SLA.0000000000003827. doi:10.1097/SLA.0000000000003827
  • Among the Medicare patient population who undergo elective surgery, 55% were opioid naïve while the remaining 45% filled one or more opioid prescriptions in the 12 months before surgery.
  • Higher levels of preoperative opioid exposure were associated with higher rates of opioid-related readmissions, pain-related readmissions, respiratory-related readmissions, and all-cause readmissions.

Substance Use Disorder General Publications

Classifying Preoperative Opioid Use for Surgical Care

Vu JV, Cron DC, Lee JS, et al. Classifying Preoperative Opioid Use for Surgical Care. Ann Surg. 2020;271(6):1080-1086. doi:10.1097/SLA.0000000000003109
  • Preoperative opioid use is common among patients who undergo elective surgery, with 38% filling an opioid prescription in the 12 months before surgery.
  • Even minimal opioid use before surgery increases the probability of needing additional postoperative prescriptions in the 30 days after surgery.

Care Coordination for Patients on Chronic Opioid Therapy Following Surgery

Lagisetty P, Bohnert A, Goesling J, et al. Care Coordination for Patients on Chronic Opioid Therapy Following Surgery: A Cohort Study. Ann Surg. 2020;272(2):304-310. doi:10.1097/SLA.0000000000003235
  • 10% of patients did not have a usual prescriber preoperatively and were more likely to have prescriptions from multiple prescribers and new long-acting opioid prescriptions.
  • 73.8% of patients were exposed to high risk prescribing postoperatively.

Piloting a statewide emergency department take-home naloxone program: Improving the quality of care for patients at risk of opioid overdose

Dora-Laskey A, Kellenberg J, Dahlem CH, English E, Gonzalez Walker M, Brummett CM, Kocher KE. Piloting a statewide emergency department take-home naloxone program: Improving the quality of care for patients at risk of opioid overdose. Acad Emerg Med. 2022 Apr;29(4):442-455. doi: 10.1111/acem.14435. Epub 2022 Jan 28. PMID: 34962682.
  • Total of 2400 naloxone kits were assembled and shipped to 9 hospitals in Michigan. By February 2021, 872 kits were distributed to ED patients 
  • Sites dispensed an average of 1.05 kits per month per 1000 ED visits 
  • 140 providers were trained in use of medications for OUD acute care settings

Association of Opioid Overdose Risk Factors and Naloxone Prescribing in US Adults

Lin LA, Brummett CM, Waljee JF, Englesbe MJ, Gunaseelan V, Bohnert ASB. Association of Opioid Overdose Risk Factors and Naloxone Prescribing in US Adults. J Gen Intern Med. 2020;35(2):420-427. doi:10.1007/s11606-019-05423-7
  • Among those who filled naloxone, 94% were patients who had received an opioid during the study period  
  • < 2% of patients in overdose risk factor groups filled naloxone
  • Despite increases in naloxone prescribing, the prevalence of naloxone fills by patients at high risk of overdose remains minimal

Opioid Prescribing General Publications

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