New Persistent Opioid Use After Surgery: A Risk Factor for Opioid Use Disorder?

Drug overdose deaths in the US recently reached a record level of 93,000 in 2020. 1 Recent estimates suggest that 1.6 million Americans have an opioid use disorder (OUD) and 10 million misuse opioids.While the alarming rise in deaths is mostly due to illicit fentanyl, inappropriate surgical prescribing is widely recognized as a contributor to inappropriate opioid use for several reasons. 2 First, over-prescribing remains common, despite recent efforts to mitigate excess post-discharge prescribing and reduce opioid use after surgery.3 Moreover, unused opioids are infrequently disposed, creating a reservoir of pills available for unintended use.Finally, surgery remains the first time many patients take prescription opioids, which exposes patients to risk of long-term use.As such, surgeons have a responsibility to prevent poor opioid-related outcomes, particularly among those who are most vulnerable.Here, we outline the clinical complication of new persistent opioid use, describe its relationship with opioid use disorder, and provide context on implications for surgical care.