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.