New Opioid Persistence in Veterans Following Major and Minor Surgery

Area of Science:

• Medical Research
• Clinical Outcomes
• Veteran Health

Background:

• Opioid use for postsurgical pain management can lead to problematic long-term use, affecting 0.4%-7% of civilians.
• Veterans are at higher risk for substance use disorders and overdose due to trauma exposure.
• Understanding opioid persistence in veterans is crucial for targeted interventions.

Purpose of the Study:

• To determine the prevalence of persistent opioid use after surgery in a veteran population.
• To identify patient characteristics associated with increased risk of long-term opioid use.

Main Methods:

• Retrospective chart review of 1,257 opioid-naïve veterans undergoing surgery.
• Data collected on patient demographics, health conditions, and post-discharge opioid prescriptions.
• Incidence of opioid use beyond 90 days post-surgery was calculated.

Main Results:

• The incidence of persistent opioid use was approximately 3.3% for major and 3.4% for minor procedures.
• Opioid persistence rates were similar across age groups: <45 years (3.3%), 45-64 years (4.3%), and ≥65 years (2.2%).
• Cancer (OR 2.13), mental health disorders (OR 2.32), and substance use disorders (OR 2.09) were associated with increased risk.

Conclusions:

• Just over 3% of opioid-naïve veterans developed persistent opioid use within 3 months post-surgery.
• Procedure type and patient age did not significantly influence opioid persistence.
• Cancer and a history of mental health or substance use disorders are significant risk factors for persistent opioid use in veterans.