Opioid medications such as codeine and oxycodone often are prescribed after surgery to relieve post-operative pain. The availability of such drugs is also well known to be a major factor in increasing rates of addiction and addiction-related overdose deaths. A new study suggests that giving opioid prescriptions after simple operations may create some of those problems.
The study, published Monday in the Archives of Internal Medicine, looked at 391,139 people age 66 or older who had a short-stay surgery for something minor like cataracts, laparoscopic gallbladder removal, prostate tissue removal or varicose vein stripping. Among this group, about 7% were prescribed an opioid within seven days of the surgery and 7.7% were prescribed opioids one year after the surgery. Ten percent of that group of patients were considered long-term opioid users.
Some individuals in the study probably had developed pain conditions legitimately requiring use of opioid medications. But it’s also possible that use of the medications created dependence in other patients, the authors noted. Compared to people who did not get an opioid prescription after surgery, those who received a prescription were 44 times more likely to be classified later as long-term opioid users.
After minor surgery, patients are often given a prescription for codeine or oxycodone “on the expectation of postoperative pain,” the authors wrote. But the medications may be misused. Moreover, keeping the unused bottle of pills in the medicine cabinet “presents a readily available source of opioid diversion among certain surgical patients.”
Doctors may want patients to try non-opioid pain relievers first after minor surgery, said the author of a commentary accompanying the study. When it comes to opioid use for minor surgery, the editorial noted, “less is more.”