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Review of Risk Factors for Opioid Misuse and Addiction Following Traumatic Injury.

Nicholas J Lawler1, Bipasha Sobhani2, Ejura Yetunde Salihu3

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Summary

Traumatic injuries increase opioid misuse risk. Understanding patient, injury, and prescribing factors is key to preventing opioid use disorder (OUD) in trauma survivors.

Keywords:
addictionopioid misuseopioid use disorderopioidspain managementprescription opioidsprolonged opioid userisk factorstrauma patientstraumatic injury

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Area of Science:

  • Trauma and Injury Research
  • Pain Management
  • Addiction Medicine

Background:

  • Traumatic injuries affect millions globally, requiring acute pain management often involving opioid analgesics.
  • Opioid use in trauma survivors carries a significant risk of developing persistent use, misuse, or opioid use disorder (OUD).
  • Pre-existing patient factors and injury characteristics can escalate the risk for opioid misuse and addiction post-trauma.

Purpose of the Study:

  • To review multifactorial contributors to opioid misuse and addiction following traumatic injury.
  • To identify patient-level, injury-related, and system-level risk factors for opioid misuse trajectories.
  • To inform clinical decision-making for pain management and OUD prevention in trauma survivors.

Main Methods:

  • Comprehensive literature search from 1995 to November 2025 in PubMed/MEDLINE, Scopus, and Google Scholar.
  • Used keywords related to 'opioids,' 'misuse,' 'addiction,' 'trauma,' and 'injury,' with librarian collaboration.
  • Included review of reference lists; excluded case reports, editorials, and qualitative studies.

Main Results:

  • Summarizes patient-level factors (demographics, behavioral health), injury characteristics (severity, type), and system-level factors (prescribing patterns).
  • Highlights the interaction between pre-injury determinants and injury-related factors in escalating OUD risk.
  • Identifies a gap in evidence-based clinical decision support for post-traumatic opioid risk.

Conclusions:

  • Opioid misuse and addiction post-trauma are multifactorial, influenced by patient, injury, and system-level characteristics.
  • Further research is needed to develop evidence-based clinical decision support tools for managing post-traumatic pain and preventing OUD.
  • Insights can improve pain management strategies, address co-occurring conditions, and mitigate substance misuse risks in trauma survivors.