Opioid Medication Refills After Surgery Associated With Unhealthy Opioid Use and Use Disorder Among Family Members

Many individuals are prescribed opioid medications after surgery; this can lead to unhealthy opioid use and opioid use disorder (OUD). Moreover, previous studies suggest that receipt of prescribed opioid medications by 1 person increases the risk of unhealthy opioid use and OUD among other people in their household. Researchers used 2008–2016 data from a large US commercial insurer to investigate the association of receiving an opioid medication prescription and refills after surgery, and the development among family members of “chronic” opioid use (defined as >90 days) or unhealthy opioid use (i.e., an ICD-10 diagnosis of opioid “dependence,” “abuse,” or overdose).

  • Over the study period, 843,531 unique pairs of patient and family members met criteria for inclusion; 36% were in households with 0 opioid prescriptions and 47% with only 1 prescription; the remainder (17%) received at least 1 refill.
  • Compared with households with 0 prescriptions, family members in households with only 1 prescription did not have a significantly higher hazard of unhealthy opioid use or “chronic” opioid use.
  • Rates were significantly higher when there was a refill, with a 19% increase in the hazard of unhealthy opioid use, and a 22% increase in “chronic” opioid use with each additional refill.

Comment: This study reinforces prior observations that even short-term exposure to opioid medications may lead to unhealthy use and OUD, and that these risks extend to family members. These estimates are probably conservative due to their reliance on ICD-10 diagnoses. These results support limiting the prescribing of opioid medications, even when intended for short-term use.

Darius A. Rastegar, MD

Reference: Agniel D, Brat GA, Marwaha JS, et al. Association of postsurgical opioid refills for patients with risk of opioid misuse and chronic opioid use among family members. JAMA Netw Open. 2022;5(7):e2221316.

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