Opioid Use and Pain Resolution for Acute Pain Among Opioid-Naive Patients

Area of Science:

• Pain Management
• Pharmacology
• Public Health

Background:

• Evidence guiding opioid prescribing for acute pain is limited.
• Understanding pain trajectories and treatment patterns is crucial for effective management.

Purpose of the Study:

• To describe pain trajectories and patterns of opioid/nonopioid treatment use in patients offered opioids for acute pain.
• To inform evidence-based guidelines for acute pain management.

Main Methods:

• Prospective cohort study of 1708 opioid-naive patients across 5 US health systems.
• Data collected via digital questionnaires over 180 days, assessing pain resolution, treatment use, and adverse effects.
• Included diverse pain sources such as dental, trauma, obstetric, musculoskeletal, and low back pain.

Main Results:

• Median time to pain resolution was 20 days, longer for surgical and low back pain.
• Opioid use was generally low-dose (median 10 MME/day) and short-term (median 7 days to discontinuation).
• Approximately 10% of patients used opioids for ≥90 days; most reported leftover opioids.

Conclusions:

• Opioid use for acute pain is often short-term and low-dose, but prolonged use occurs in a subset of patients.
• Pain resolution timelines vary significantly by diagnosis, necessitating tailored treatment approaches.
• Current guidelines for multimodal and short-duration opioid prescriptions are beneficial but require individual patient consideration.