Opioid Dependency After Craniomaxillofacial Trauma Surgery.

Area of Science:

• Pain Management
• Public Health
• Surgical Outcomes

Background:

• The opioid crisis contributes to significant morbidity and mortality.
• Opioid overdoses are a major concern, with a portion linked to prescribed opioids.
• Previous research indicated 39% of opioid prescriptions post-craniomaxillofacial (CMF) trauma were potentially inappropriate.

Purpose of the Study:

• To identify factors associated with potentially inappropriate and prolonged opioid prescriptions.
• To analyze these factors in postoperative CMF trauma patients.

Main Methods:

• Retrospective cohort study utilizing Merative™ MarketScan® databases (2015-2022).
• Identified patients undergoing CMF trauma surgery, stratified by insurance type (commercial vs. Medicaid).
• Investigated associations between prolonged opioid prescription length and demographic, comorbid, and surgical factors.

Main Results:

• 23,985 patients received postoperative opioid prescriptions after CMF trauma surgery.
• Average prescription length was shorter for commercially insured patients (24.6 days) vs. Medicaid patients (33.7 days).
• 22% of prescriptions were deemed potentially inappropriate; chronic pain, overlapping prescriptions, and extended-release formulations increased odds of long-term use.

Conclusions:

• Potentially inappropriate opioid prescriptions post-CMF trauma surgery decreased to 22% but remain linked to prolonged use.
• Providers should verify existing prescriptions before issuing new ones.
• Avoid dispensing extended-release opioid formulations in the acute postoperative setting.