Association of new opioid continuation with surgical specialty and type in the United States.

BACKGROUND: The consequences of opioids-including post-surgical prescriptions-remain a critical public health issue. We sought to determine how procedure type and subspecialty group influence new opioid use after procedures.

METHODS: We analyzed 2011-2015 IBM MarketScan Research Databases to identify opioid-naïve adults prescribed opioids for single surgical procedures. We defined new opioid continuation (primary outcome) a priori as receipt of prescription opioids between 90 and 180 days after the procedure.

RESULTS: Among 912,882 individuals, new opioid continuation was higher for non-operating room compared to operating room procedures (13.1% versus 9.2%; aOR 1.61; 95% CI 1.59-1.64) and higher for subspecialties including colorectal surgery (aOR 1.35; 95% CI 1.26-1.43) and cardiovascular surgery (aOR 1.30; 95% CI 1.12-1.50) compared to urology as a referent. New opioid continuation was also associated with perioperative opioid prescription dosage, days' supply, preoperative receipt, and multiple prescriptions.

CONCLUSIONS: Opioids prescriptions associated with non-operating room surgical exposures appear to confer higher risk regarding conversion to new long-term opioid use.