Is Opioid Prescribing Driving Trauma Recidivism or Is Trauma Driving Opioid Use?

Area of Science:

• Trauma Surgery
• Addiction Medicine
• Public Health

Background:

• Opioid prescription rates have surged, leading to increased overdose admissions.
• Research on trauma recidivism often overlooks opioid use, focusing instead on alcohol and trauma history.

Purpose of the Study:

• To investigate the association between opioid use and trauma recidivism.
• To identify predictors of recurrent opioid use among patients with multiple trauma admissions.

Main Methods:

• Retrospective review of 1,649 patients with multiple trauma admissions (age ≥18).
• Analysis of demographics, opioid toxicology screen (TS) results, and injury characteristics for 709 patients with data from both admissions.
• Statistical analysis using chi-squared and Poisson regression models.

Main Results:

• 31% of patients tested positive for opioids on their first admission, rising to 34% on their second.
• Patients positive for opioids on the first admission were significantly more likely to be positive on the second (55% vs. 25%, P < 0.0001).
• Opioid-positive patients on subsequent admissions had less severe injuries (ISS > 15, 26.3% vs. 22.3%, P = 0.04).
• Previous opioid use was the strongest predictor of recurrent use (RR = 2.18, P < 0.001).

Conclusions:

• A history of opioid use is the most significant predictor of recurrent opioid use in trauma recidivists.
• Opioid use is associated with trauma recidivism, highlighting a critical area for intervention.
• Future research should explore targeted interventions for trauma patients with a history of opioid use.