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Who Gets Hooked on Opioids After Surgery?

by Dr. Sharon Orrange on September 2, 2016 at 3:10 pm

Many patients report becoming hooked on their opioid medications (like Vicodin, Percocet, Dilaudid, hydrocodone, and so on) after doctors prescribed them for postoperative pain.

If you’ve never used pain medications and are given them for pain after a procedure, who is most likely to have a problem down the line? Well, a recent JAMA study evaluated the risk for chronic opioid use following several common surgical procedures in opioid-naive patients (people who have never used opioid medications before).

Here’s what they found:

  • Patients who had never taken opioids before, also known as “opioid-naive patients” undergoing certain common surgical procedures were found to be at higher risk of developing chronic opioid use in the subsequent year compared to patients not undergoing surgery.
  • Which surgeries most often result in dependence and chronic opioid use?
    • Knee replacement was the winner—those taking opioids for a total knee replacement were at the highest risk
    • Hip replacement
    • Gallbladder removal
    • Simple mastectomy
    • Appendectomy, but not laparoscopically—the risk is higher with an “open” appendectomy
    • Cesarean delivery
  • What were other risk factors for chronic opioid use after taking them for post surgical pain? Age greater than 50 years, being a man, history of depression, alcohol or drug abuse, and preoperative use of benzodiazepines (Xanax, Valium, Ativan) or antidepressants.
  • What types of surgery don’t come with a higher risk of becoming dependent? Prostate surgery (TURP), cataract surgery, sinus surgery or laparoscopic appendectomy. You seem to be in the clear with those.

Interesting, right?

Dr O.

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