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Individual and Family-Level Risk Factors of Daily Opioid Use in Adolescents Following Spinal Fusion Surgery
Patricia Dionicio1, Cornelius B Groenewald1, Tonya Palermo2,3
1Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA.
The Clinical Journal of Pain
|July 23, 2026
Summary
Adolescents undergoing spinal fusion surgery who have poorer family functioning face higher odds of daily opioid use. Postoperative pain severity also increases daily opioid use, but this risk decreases with each day after surgery.
Area of Science:
- Orthopedics
- Adolescent Medicine
- Pain Management
- Psychology
Background:
- Adolescent opioid use after surgery is a concern, with significant variability in usage patterns.
- Predictors of daily opioid use in adolescents following major musculoskeletal surgery are not well understood.
- Understanding these predictors is crucial for developing targeted interventions and preventing future misuse.
Purpose of the Study:
- To investigate the association between pre-existing individual and family factors, and postoperative clinical risk factors with daily opioid use in adolescents undergoing spinal fusion.
- To identify key predictors of daily opioid consumption in this vulnerable population.
Main Methods:
- Prospective longitudinal cohort study involving adolescents post-spinal fusion surgery.
- Assessment of preoperative factors (e.g., family functioning, pain intensity, mental health) and postoperative factors (e.g., pain severity, pain interference).
- Multilevel logistic regression models were used to analyze daily opioid use over 30 days post-surgery.
Main Results:
- 83% of participants reported opioid use during the 30-day postoperative period.
- Poorer family functioning was linked to increased daily opioid use (OR=1.27).
- Higher daily pain severity increased concurrent opioid use (OR=1.85), while each postoperative day decreased opioid use (OR=0.40).
Conclusions:
- Family functioning emerged as a significant preoperative predictor of adolescent opioid use.
- Daily pain severity was a critical within-person postoperative risk factor for opioid use.
- Screening for family functioning may aid in identifying adolescents and families needing targeted opioid education and support.
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