Academic Journal
Trends and Patterns of Postoperative Opioid Exposure Among Surgical Patients After the 2016 Center for Disease Control Guideline for Prescribing Opioids.
| Τίτλος: | Trends and Patterns of Postoperative Opioid Exposure Among Surgical Patients After the 2016 Center for Disease Control Guideline for Prescribing Opioids. |
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| Συγγραφείς: | Elemosho A; Department of Surgery, Tufts Medical Center, Boston, Massachusetts; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Chatzipanagiotou OP; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Angez M; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Baldo A; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Mevawalla A; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Alizai Q; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Pawlik TM; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio. Electronic address: tim.pawlik@osumc.edu. |
| Πηγή: | The Journal of surgical research [J Surg Res] 2026 Oct; Vol. 326, pp. 619-629. Date of Electronic Publication: 2026 Aug 10. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: New York, NY : Academic Press Original Publication: Philadelphia [etc.] |
| Ιατρικοί όροι (MeSH): | Analgesics, Opioid*/adverse effects , Analgesics, Opioid*/therapeutic use , Analgesics, Opioid*/administration & dosage , Postoperative Pain*/drug therapy , Postoperative Pain*/etiology , Opioid-Related Disorders*/epidemiology , Opioid-Related Disorders*/etiology , Opioid-Related Disorders*/prevention & control , Practice Patterns, Physicians'*/standards , Practice Patterns, Physicians'*/statistics & numerical data , Practice Patterns, Physicians'*/trends, United States/epidemiology ; Centers for Disease Control and Prevention, U.S./standards ; Drug Prescriptions/statistics & numerical data ; Drug Prescriptions/standards ; Humans ; Male ; Female ; Middle Aged ; Practice Guidelines as Topic ; Adult ; Aged ; Retrospective Studies |
| Περίληψη: | Introduction: Perioperative opioid exposure remains a public health concern because short-term postoperative prescribing may be associated with persistent opioid use and downstream substance-related harms. We examined postoperative opioid exposure, persistent opioid use, and substance use disorder (SUD) diagnoses among opioid-naive surgical patients before and after the 2016 Center for Disease Control and Prevention (CDC) opioid-prescribing guideline. Methods: Electronic health record data from the All of Us Research Program were used to identify opioid-naive adults undergoing qualifying surgical procedures from 1983 to 2023. Acute opioid-related events were defined as opioid-related safety or documentation signals within 30 d of surgery, including naloxone or naltrexone administration or opioid-related diagnoses. Persistent postoperative opioid use was defined as recurrent opioid exposure during postoperative days 31-180 among patients without opioid exposure in the prior year. Long-term SUD was defined as a new diagnosis of opioid, alcohol, nonopioid drug, or polysubstance use disorder after the early postoperative period and within 5 y. Results: Among 13,240 opioid-naive surgical patients, 5748 (43.4%) had documented opioid exposure within 30 d of surgery. Acute opioid-related events occurred in 674 patients (5.1%). Persistent opioid use occurred in 116 patients (0.9% overall; 2.0% among those with 30-d opioid exposure). Any SUD diagnosis within 5 y occurred in 790 patients (6.0%). In adjusted models, each additional day of opioid supply within postoperative days 0-30 was associated with higher odds of persistent opioid use (adjusted odds ratio 1.04 per day, 95% confidence interval 1.03-1.04) and 5-y SUD (adjusted odds ratio 1.01 per day, 95% confidence interval 1.01-1.02). Total morphine milligram equivalent (MME) dose was associated with persistent opioid use but not independently associated with 5-y SUD. Interrupted time series analysis demonstrated a reduction in mean postoperative MME immediately after the 2016 CDC guideline and a negative postguideline slope change in persistent opioid use and 5-y SUD rates. Conclusions: Among opioid-naive surgical patients, longer postoperative opioid duration was associated with persistent opioid use and subsequent SUD diagnoses. The 2016 CDC guideline was temporally associated with lower postoperative MME and changing opioid-related outcome trends, although causal attribution cannot be inferred from this retrospective observational design. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: CDC opioid guideline; Morphine milligram equivalents; Opioid prescribing; Opioids; Persistent opioid use; Postoperative pain; Substance use disorder; Surgery |
| Substance Nomenclature: | 0 (Analgesics, Opioid) |
| Entry Date(s): | Date Created: 20260810 Date Completed: 20261008 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1016/j.jss.2026.07.013 |
| PMID: | 42574953 |
| Βάση Δεδομένων: | MEDLINE |
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