Study finds common surgeries may serve as pathway to nonmedical opioid use in adolescents

September 15, 2017

CHICAGO - Research being presented at the American Academy of Pediatrics 2017 National Conference and Exhibition shows that post-surgical opioid pain medications prescribed after common surgeries may become a pathway to continued, nonmedical opioid use by teens and young adults.

The study abstract, "Persistent Opioid Usage among Pediatric Patients Following Surgery in the United States," will be presented on Sunday, Sept. 17, at the Marriott Marquis Chicago.

Researchers examined data including nearly 90,000 privately insured U.S. patients between ages 13 and 21 (averaging age 17) with no previous opioid prescriptions who underwent one of 13 common surgeries for this age group, compared with a control sample. They looked for persistent opioid use, defined as continued prescription refills 90 to 180 days after the surgical procedure and beyond what is expected after routine surgery.

They found the incidence of new persistent opioid use following surgery was 4.8 percent, ranging from 2.7 percent to 15.2 percent across procedures, as compared to 0.1 percent in the nonoperative control group.

Gallbladder removal and colon surgery were among procedures associated with highest risk of new persistent opioid use, said lead abstract author Calista Harbaugh, M.D., a general surgery resident at the University of Michigan Medical School and pediatric surgery researcher at C.S. Mott Children's Hospital and the Michigan Opioid Engagement Network. In addition, they found older youth with additional chronic conditions, depression, anxiety or prior substance use disorders were at higher risk.

"Opioids are commonly prescribed for pain after surgery, and until recently it was generally believed they were not addictive," Harbaugh said. Recent research has shown that many adults are chronically using opioids after surgery, she said, but this is the first to show that long-term opioid use may also be a significant problem for adolescents and young adults who have surgery.

"The study is an important step toward recognizing that the opioid epidemic is affecting adolescents and young adults in a major way," Harbaugh said, noting that when a refill is provided, the opioid pills may have been used, or they may have been saved or given to someone else in the community.

"Most adolescents who misuse prescription opioids get the pills from leftover prescriptions of their family, friends, or their own," she said. "We need to make sure that we treat pain after surgery, but it must be balanced with the risk of providing more opioid than necessary to patients and their communities."
Harbaugh will present the abstract, funded by the Michigan Department of Health & Human Services and available below, on Sunday, Sept. 17 from 11:57 a.m. to 12:02 p.m. in the Marriot Marquis Chicago in Grand Horizon D-G.

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.

The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit

Abstract Title: Persistent Opioid Usage among Pediatric Patients Following Surgery in the United States

Purpose: In recent years, opioid prescribing in the United States has soared, and has been followed by rising rates of nonmedical prescription opioid and heroin abuse. Recent studies demonstrate that postoperative care is an important risk factor for new opioid dependence. The purpose of this study is to investigate incidence of new persistent opioid use after surgery among opioid-naïve adolescents. Methods: We performed a retrospective cohort study including privately insured opioid-naive adolescents (13-21 years), who underwent one of thirteen common surgeries (Truven Marketscan, January 1, 2010-June 30, 2015). As a comparison, we included a random sample of 3% of patients aged 13 to 21 years without procedural codes or opioid prescriptions across a similar time period prior to a randomly assigned fictitious surgery date. The primary outcome was new persistent opioid use, defined as continued opioid prescription fills captured by pharmacy claims between 90 and 180 days after the index surgical procedure. Results: The surgical cohort included 88,637 patients (mean age: 17.1±2.4 years). The incidence of new persistent opioid use following surgery was 4.8%, ranging from 2.7% to 15.2% across procedures, as compared to 0.1% in the nonoperative control group. Procedures associated with higher risk of new persistent opioid use were cholecystectomy (adjusted odds ratio [aOR], 1.191; 95% CI, 1.062-1.335) and colectomy (aOR, 2.753; 95% CI, 1.222-6.203). Risk factors independently associated with new persistent opioid use included older age (aOR, 1.068; 95% CI, 1.054-1.082), female gender (aOR, 1.241; 95% CI, 1.160-1.329), higher comorbidity score (aOR, 1.015; 95% CI, 1.007-1.022), anxiety (aOR, 1.179; 95% CI, 1.004-1.384), and substance and drug use (aOR, 1.460; 95% CI, 1.163-1.833). Conclusion: New persistent opioid use after surgery is common and may represent a significant pathway to nonmedical opioid use among adolescents. Identifying safe, evidence-based practices for perioperative pain management among adolescents is a top priority.

American Academy of Pediatrics

Related Pain Articles from Brightsurf:

Pain researchers get a common language to describe pain
Pain researchers around the world have agreed to classify pain in the mouth, jaw and face according to the same system.

It's not just a pain in the head -- facial pain can be a symptom of headaches too
A new study finds that up to 10% of people with headaches also have facial pain.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

The insular cortex processes pain and drives learning from pain
Neuroscientists at EPFL have discovered an area of the brain, the insular cortex, that processes painful experiences and thereby drives learning from aversive events.

Pain, pain go away: new tools improve students' experience of school-based vaccines
Researchers at the University of Toronto and The Hospital for Sick Children (SickKids) have teamed up with educators, public health practitioners and grade seven students in Ontario to develop and implement a new approach to delivering school-based vaccines that improves student experience.

Pain sensitization increases risk of persistent knee pain
Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM).

Becoming more sensitive to pain increases the risk of knee pain not going away
A new study by researchers in Montreal and Boston looks at the role that pain plays in osteoarthritis, a disease that affects over 300 million adults worldwide.

Pain disruption therapy treats source of chronic back pain
People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting.

Sugar pills relieve pain for chronic pain patients
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology.

Peripheral nerve block provides some with long-lasting pain relief for severe facial pain
A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

Read More: Pain News and Pain Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to