Opioid consumption in the first 30 days after surgery was independently associated with new persistent opioid use

Previous studies suggest that new persistent opioid use (NPOU) after surgery was associated with larger perioperative opioid prescriptions, but the association between NPOU and postoperative opioid consumption is unknown.

This retrospective study included opioid naïve individuals aged 18-64 who underwent surgical procedures across 70 Michigan hospitals between July 1, 2018 and November 15, 2021 and were prescribed opioids at discharge. We used clinical and patient-reported opioid consumption data from the Michigan Surgical Quality Collaborative, a statewide surgical registry, linked with the state Prescription Drug Monitoring Program. Multivariable logistic regression modeling was used to assess the association between patient-reported opioid consumption during the 30 days after discharge and NPOU, defined as having an opioid fill during both 31-120 days and 121-210 days after discharge.

Among 36,271 patients included, 482 (1.3%) developed NPOU. These patients consumed more opioid pills in the first 30 days postoperatively than those without NPOU (mean (SD): 7.3 (8.4) 5 mg oxycodone equivalent pills vs 4.1 (5.5), SMD=-0.41). In adjusted analyses, each additional opioid pill consumed in the 30-day postoperative period was associated with a 0.05 percentage-point increase in the predicted probability of NPOU (95% CI 0.04 to 0.07 percentage points). Thus, holding all other variables constant, a 10-pill increase in consumption would be associated with a 0.5 percentage-point increase in the probability of NPOU, or a 38.4% increase relative to the baseline rate of 1.3%.

Demonstrating that opioid consumption in the first 30 days after surgery was independently associated with NPOU underscores the importance of perioperative opioid prescribing on long-term outcomes.