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.
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.
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.
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.
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.
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
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
