Chronic opioid use risk increased in spinal deformity patients with 4 or more years of pain


A new Johns Hopkins Medicine study published in the July issue of Spine Deformity found that patients who undergo adult spinal deformity operations and use opioids for four or more years before surgery have higher odds of relying on post-surgery opioids chronically. 

Baltimore-based Johns Hopkins researchers selected 119 patients who underwent ASD surgery between January 2008 and February 2018 and analyzed their opioid usage at pre- and postoperative appointments. 

Researchers analyzed data on the patients' physical and mental health reported during their one- and two-year post-op follow-up appointments, as well as their frequency of opioid dosages. 

The research found that many factors — including sex, weight, race, age and tobacco use — had nothing to do with postoperative opioid use. 

However, they did find that patients who used opioids before their operations were six times more likely to rely on opioids following the surgeries. 

Patients who experienced four or more years of chronic pain before ASD surgery were three times more likely to report chronic opioid use. 

"Physicians can explain that while most patients do not become addicted to opioids, preoperative opioid use and duration of preoperative pain may increase that risk," Brian Neuman, MD, an associate professor of orthopedic surgery at Johns Hopkins University School of Medicine and an author on the study, said in a July 13 news release. 

"For patients with multiple risk factors and those concerned about addiction, physicians can offer alternative pain management methods, such as non-narcotic medications, and provide early referrals to pain management specialists." 

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