Redefining Opioid Use Patterns After Surgical Procedures: Why a New Paradigm Is Critical

Abstract

The risk of developing an opioid use disorder after an elective operation is increasingly recognized. 1 Within the surgical population, patients undergoing major spine operations represent a high-risk cohort: approximately 20% to 70% of patients use opioids prior to operations, preoperative patientreported pain scores are high, and 50% to 60% of patients have undergone a previous spine procedure. 2 The study by Warner et al 3 addresses an important gap in knowledge regarding patterns of opioid use after major spine operations.

Association of Physical Therapy Interventions With Long-term Opioid Use After Total Knee Replacement

“…Hence, further work is needed to understand the relative association of active and passive PT interventions with outcomes in outpatient settings after TKR.Similar to prior studies, 32.5% to 35.0% of opioid-experienced individuals and 2.2% to 2.4% of opioid-naive individuals in our study had long-term opioid use after TKR 8,9,23,24,[45][46][47][48]. Although the incidence of long-term opioid use among opioid-naive individuals is lower than among those with JAMA…”

“…Similar to prior studies, 32.5% to 35.0% of opioid-experienced individuals and 2.2% to 2.4% of opioid-naive individuals in our study had long-term opioid use after TKR. 8 , 9 , 23 , 24 , 45 , 46 , 47 , 48 Although the incidence of long-term opioid use among opioid-naive individuals is lower than among those with prior opioid use, these results are concerning given the large number of TKR surgical procedures performed annually in the US and projected increases in this surgery in the future. 5 Our results suggest that pre-TKR and post-TKR PT interventions are associated with lower risk of long-term opioid use regardless of prior opioid use.…”