Opioid use disorder treatment lowers risk of overdose after surgery, study finds

Although individuals with opioid use disorder (OUD) are significantly more prone to overdose or have a complication after major surgery than those without the disorder, using medications for the treatment of OUD before surgery may eliminate that extra risk, suggests a big, first-of-its-kind study presented on the ANESTHESIOLOGY^® 2023 annual meeting.

Patients with OUD who didn’t use an OUD medication (reminiscent of buprenorphine or methadone) were over 4 times more prone to overdose after having surgery, yet those that used evidence-based OUD medication before surgery were essentially at no greater risk than those that did not have OUD, in line with the study. Taken orally, OUD medications reduce withdrawal and cravings and stop opioids from producing the sensation of euphoria that drives addiction.

We all know that OUD treatments are very effective in helping to stop relapse, overdose and death in nonsurgical patients, but our research is the primary to indicate that in addition they could also be remarkably effective in at-risk patients facing surgical stress and recovery pain that always is addressed with opioids. This helps us learn more about how you can optimally treat OUD patients in order that their surgical and post-surgical pain is well-controlled, while also ensuring we’re minimizing their risk of relapse and overdose.”

Anjali Dixit, M.D., MPH, pediatric anesthesiologist at Stanford University, California

Researchers analyzed 4,030,032 surgeries performed between 2008 and 2020 from the Merative MarketScan Business Database, a nationwide sample of information from patients with each employer-sponsored and Medicare Advantage insurance. The evaluation reviewed overdoses and other complications (reminiscent of OUD-related hospitalization or infection) that occurred within the three months after surgery for the 25 most typical surgeries, including knee and hip substitute, hysterectomy and gallbladder removal.

Of the over 4 million surgeries, 26,827 were performed on patients who had a history of OUD, 9,699 (36%) of whom used OUD medications within the month before surgery and 17,128 (64%) who didn’t. OUD patients who didn’t use OUD medications were 4.2 times more prone to overdose or have an OUD-related infection or hospitalization than those that didn’t have the disorder, in line with the study. OUD patients who used OUD medications didn’t experience a statistically different risk of opioid-related opposed events in comparison with those that didn’t have the disorder.

As many as 7.6 million people within the U.S. live with OUD, in line with research, and that number continues to grow. Only 20% of individuals with OUD currently use OUD medications, said Dr. Dixit. She noted the number of individuals within the study who used OUD medications was likely higher, because that they had access to business insurance and due to this fact, higher access to care. The researchers also want to have a look at other populations reminiscent of those on Medicaid, because they could be sicker and have less access to care.

“The national efforts to extend access to OUD medications is sweet news for individuals with OUD, including those that need surgery,” said Dr. Dixit. “The subsequent step is to find out if a selected medication or regimen is best than one other.”