Surgery Is Not The Reason For Most New Opioid Use, Study Says

Only 1.1% of people with long-term opioid use got the meds after an inpatient encounter, according to a new research letter.

With more Americans getting hooked on opioids, the use of opioid painkillers after surgery has come under scrutiny—but a new study shows that people are much more likely to use painkillers long term if they receive their first opioid prescription for chronic pain, rather than after a surgical procedure.

A new research letter published in the Journal of the American Medical Association (JAMA) showed that only 1.1% of people who used opioids long term (six months or more) first got the medications after a surgery or other "inpatient encounters." Surgery was not one of the top 10 reasons that people who used opioids long term started taking the drugs.

People with long-term use were more likely to have received opioid prescriptions initially for “other ill-defined conditions,” an insurance code that covers ailments like chronic pain. More than 30% of people who used opioids long term started taking the painkillers for that reason.

“The initial event associated with exposure to prescription opioids has not been widely explored, but is often maintained to stem from an injury or surgical procedure,” the authors wrote. “As we search for causes of the opioid epidemic, we note that hospital events and associated procedures do not appear to be the main drivers,” according to the LA Times.

Instead, initial prescriptions that led to long-term use were more likely to be written for chronic pain “for which opioid administration is not considered standard of care.”

In March of 2016, the Centers for Disease Control and Prevention (CDC) released updated guidelines for treating chronic pain. The guidelines called for opioids to be prescribed at lower dosages and for doctors to explore other alternatives for treating pain.

“There is insufficient evidence that opioids control chronic pain effectively over the long term, and there is evidence that other treatments can be effective with less harm,” notes one infographic for primary care providers.

According to the CDC, “Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs.”

Although the new report shows that surgery is not the main cause for long-term opioid use, about 6% of people who get surgery will use opioids for more than 90 days after surgery, putting them at risk for developing addiction, according to a study published in JAMA in June.

“New persistent opioid use is more common than previously reported and can be considered one of the most common complications after elective surgery,” study authors wrote.