A recent study from Austria has shed light on the risks associated with non-prescription opioid use (NPOU) following surgery, raising awareness about the global challenge of managing post-surgical pain. The study, which analyzed data from over 550,000 patients who underwent one of 12 types of surgery between 2016 and 2021, found that 1.7% of individuals developed NPOU after surgery. Spinal surgery patients were the most affected, with a striking 6.8% incidence rate. Furthermore, knee replacements and colon surgeries also showed higher rates of NPOU.
The Austrian study highlights a significant contrast with U.S. statistics, where post-surgical NPOU rates reach as high as 7%. A separate 2021 study revealed that one in five patients continued opioid use for more than three months after a total hip or knee replacement. This discrepancy may be partly due to differences in prescribing practices, as Austrian physicians are reportedly less liberal with opioid prescriptions compared to their American counterparts. Additionally, Austria's public health insurance system might contribute to the lower NPOU rates observed.
NPOU is not necessarily indicative of addiction or misuse but is instead defined as a "complication" of surgery. It involves filling at least one opioid prescription within the first 90 days post-surgery and another within the subsequent 90 to 180 days. The study emphasizes that prior opioid use is a notable risk factor for developing NPOU, as patients who have previously used opioids are more likely to continue using them post-surgery compared to those who are "opioid naïve."
Effective pain management is crucial for a successful recovery following surgery.
“Pain relief after surgery is a key component to successful recovery after surgery,” – Mark Bicket, MD, PhD, an expert in pain management after surgery.
Untreated or undertreated pain can lead to chronic pain, posing a significant risk for NPOU. Patients are urged to communicate openly with their healthcare providers to ensure their pain is adequately managed.
“It is important for patients to communicate with their physicians if their pain is not well managed after surgery,” – Bicket, a University of Michigan anesthesiologist and pain medicine specialist.
“Poor pain management may signal a need to be examined by their surgical team. That check-in can help determine the right next step to keep their recovery on track,” – Bicket, a University of Michigan anesthesiologist and pain medicine specialist.
The findings underscore the importance of tailored pain management strategies that consider individual patient histories and potential risk factors for NPOU. Doctors and patients must work collaboratively to address pain effectively while minimizing the risk of prolonged opioid use.
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