Opioid overprescription in adolescents and young adults undergoing hip arthroscopy

Abstract

Few studies have examined factors related to the increased consumption of opioids after hip arthroscopy in adolescents and young adults. This study sought to determine prescription patterns following hip arthroscopy in this population, and to determine clinical or surgical factors associated with increased post-operative opioid use. Daily post-operative opioid intake was obtained from pain-control logbooks of adolescents and young adults who underwent hip arthroscopy between January 2017 and 2020. Study outcomes were defined as the median total number of opioid tablets consumed, total days opioids were consumed, mean daily opioid consumption and the ratio of opioids prescribed post-operatively to consumed. Clinical and surgical factors were analyzed to determine any association with opioid consumption. Fifty-eight (20%) patients returned completed logbooks. Most patients (73%) were prescribed 30 oxycodone tablets. The median number of tablets consumed was 7 (range 0–41) over a median duration of 7 days (range 1–22). The median ratio of tablets consumed to prescribed was 20%. Increasing patient age at surgery was associated with increased total number of tablets consumed (r = 0.28, P = 0.04) and to the ratio of tablets consumed to prescribed (r = 0.30, P = 0.03). Patients who were prescribed more than 30 tablets consumed on average 7.8 more tablets than patients prescribed fewer (P = 0.003). Patients who underwent regional anesthesia consumed tablets for longer compared with those who did not (median, 10 versus 4 days; P = 0.03). After undergoing hip arthroscopy, adolescents and young adult patients are commonly overprescribed opioids, consuming on average only one-fifth of the tablets prescribed.

The Impact of Marijuana Use in Patients Undergoing Spine Surgery

“…Hence, there is concern that opioids are overprescribed postoperatively. In a study of adolescents and young adults asked to log their pain control after hip arthroscopy, patients consumed an average of only 20% of the opioid tablets prescribed 16. A similar study of 100 patients undergoing knee arthroscopy demonstrated that patients used only 32.4% of prescribed tablets, with 11 patients taking none of their prescribed opioids 17.…”

“…In a study of adolescents and young adults asked to log their pain control after hip arthroscopy, patients consumed an average of only 20% of the opioid tablets prescribed. 16 A similar study of 100 patients undergoing knee arthroscopy demonstrated that patients used only 32.4% of prescribed tablets, with 11 patients taking none of their prescribed opioids. 17 Although most patients only use as much pain medication as they need, others may continue using their opioid prescription even after their pain becomes less severe.…”

“…Nevertheless, starting in the 1970s, some states began decriminalizing marijuana use, and medical access laws in the United States started being passed in the 1990s. 2,3 By 2016, 26 states had legalized MC use, 16 states had cannabidiol-only laws, and another 21 states had decriminalized various possession offenses. As of February 2022, 37 states, 3 territories, and the District of Columbia allow the medical use of cannabinoids.…”

Evaluating a health system‐wide opioid disposal intervention distributing home‐disposal bags

“…Two weeks after discharge, we invited eligible patients via email to complete a web‐based REDCap survey (Supplement S1). We selected this time point based on prior studies suggesting that up to 96.8% of patients cease using opioids by 2 weeks after discharge 41–43 . For outpatient surgery, the discharge date was the same as the surgery date.…”

“…We selected this time point based on prior studies suggesting that up to 96.8% of patients cease using opioids by 2 weeks after discharge. [41][42][43] For outpatient surgery, the discharge date was the same as the surgery date. For inpatient surgery, we used the discharge date to ensure patients had an adequate amount of time to use their opioids at home.…”