Persistent opioid use in opioid-naive adolescents and young adults undergoing surgery or dental procedures may be associated with long-term use of opioids by a relative, according to study results published in JAMA Surgery.
In this study, researchers retrospectively followed 346,251 opioid-naive patients ages 13 to 21 (average age, 17) who underwent 1 of 11 surgical or dental procedures.
Commercial claims data from private insurers were examined to determine persistent opioid use (ie, ≥1 prescription opioid fill 91-180 days after surgery) among patients with an initial opioid prescription fill (the study’s primary outcome). They also examined long-term opioid use in ≥1 family members who filled prescriptions of ≥120 days’ supply during the year preceding the procedure or filled ≥3 prescriptions 90 days before the procedure.
A total of 13,929 patients (4.0%) had ≥1 family member with long-term opioid use. In 97.4% of these cases, the family member was a parent. Of the 257,085 patients (74.3%) who received an initial opioid fill, 4.3% (n=11,016) had a family member with long-term opioid use, 22.8% of whom (n=2515) received an additional refill after 90 days.
Of patients who received an initial opioid fill but did not have a family member with long-term opioid use, 11.6% (n=28,508) received an additional postoperative refill (P <.001). Of patients who had an initial opioid fill and a family member taking opioids long term, 4.1% had persistent opioid use, compared with 2.4% of those without long-term opioid use in the family (adjusted odds ratio, 1.54).
Study limitations include the inability to generalize findings to publicly insured or uninsured patients.
“Physicians should screen young patients for long-term opioid use in their families and implement heightened efforts to prevent opioid dependence among patients with this important risk factor.”
Harbaugh CM, Lee JS, Chua K-P, et al. Association between long-term opioid use in family members and persistent opioid use after surgery among adolescents and young adults [published online February 27, 2019]. JAMA Surg. doi:10.1001/jamasurg.2018.5838