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Postoperative Opioid Pain Medication Usage Following Adult Tonsillectomy.

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Short-term, high-quantity opioid prescriptions after adult tonsillectomy in military personnel did not lead to opioid misuse, as indicated by substance abuse referrals. This suggests adequate short-term pain management is appropriate for this population.

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Area of Science:

  • Pain Management
  • Addiction Medicine
  • Military Health

Background:

  • Opioid prescriptions following tonsillectomy are common.
  • Concerns exist regarding potential opioid misuse in active duty military populations.
  • Understanding long-term outcomes of short-term, high-quantity opioid use is crucial.

Purpose of the Study:

  • To investigate if short-term, high-quantity opioid use post-tonsillectomy in active duty military members leads to opioid misuse.
  • To utilize referrals to substance abuse rehabilitation programs as a proxy measure for opioid misuse.

Main Methods:

  • Retrospective chart review of 741 active duty patients undergoing tonsillectomy (2012-2017).
  • Data included preoperative medications, postoperative opioid prescriptions (up to 12 months), and substance abuse referrals.
  • Inclusion criteria narrowed the study cohort to 658 patients.

Main Results:

  • The average opioid prescription was 70 tablets, with 93% receiving at least 60.
  • 38.6% had refills within 30 days; 25.4% received additional outpatient opioids within a year.
  • Only 2.9% were referred for substance abuse treatment (alcohol/marijuana), with no referrals for opioid misuse.

Conclusions:

  • Short-term, high-quantity opioid treatment for post-tonsillectomy pain in active duty adults did not result in measurable long-term opioid misuse.
  • Findings support the use of adequate short-term opioid analgesia for this population.
  • Active duty status may offer protective factors against opioid misuse, necessitating caution when extrapolating results.