Opioid use prior to spine surgery increases risk of long-term use, study shows


A study published in The Journal of Bone & Joint Surgery researched the effects of sustained opioid use prior to spine surgery.

Researchers identified 27,000 patients who underwent various lumbar spine surgeries between 2006 and 2014. They separated the patients into four groups:

• Exposed: Patients who had used opioids in the past, but were not actively using them at the time of the surgery (60 percent)
• Acute exposure: Patients who had their first opioid prescription within one month before surgery (34 percent)
• Immediate sustained use: Patients who had uninterrupted opioid use for less than six months before surgery (2 percent)
• Chronic sustained use: Patients who had uninterrupted opioid use for six months or longer before surgery (3 percent)

Researchers discovered 67 percent of patients stopped taking opioids within 30 days post-surgery. Eighty-six percent ended opioid use by day 90. At the six-month mark, 8.8 percent of patients were still taking opioids.

When comparing likelihood of discontinuing opioid use within six months, researchers found it was 65 percent lower in the intermediate sustained group, 74 percent lower in the chronic sustained group and 29 percent lower in the acute exposure group.

"Our results indicate the majority of patients who are using prescription opioids prior to spine surgery discontinue these medications following surgical intervention," study author Andrew Schoenfeld, MD, concluded. However, the authors noted the necessity for surgeons to recognize biopsychosocial factors associated to opioid use.

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