Surgery raises risk for relapse among patients with opioid use disorder in remission

  • Journal of Substance Abuse Treatment

  • International Clinical Digest
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Takeaway

  • Undergoing surgery was significantly associated with an increased risk for opioid misuse in patients enrolled in an opioid agonist treatment (OAT) programme for opioid use disorder (OUD).

Why this matters

  • The findings suggest that opioid use relapse is a significant surgical risk factor among patients with a history of OUD.

Study design

  • Patients (surgery, n=87; control, n=836) with OUD who had enrolled in an OAT (maintained on methadone/buprenorphine) programme were identified.
  • Funding: None disclosed.

Key results

  • In the first year postsurgery, more opioid misuse was reported in the surgical vs the control group (58% vs 31%; P<.001>
  • Number of opioid overdoses reported in the first year was 6 (2 in the surgical and 4 in the control group; P=.044).
  • Propensity score model matched 87 surgical cases with 249 control cases.
  • The matched groups showed increased odds for postoperative opioid relapse with surgery (OR, 1.91; P=.034).
  • The time from OAT enrollment to surgery was 64.1±24.0 months in the surgical group and 54.9±21.1 months in the matched control group.
  • History of alcohol use disorder was associated with increased odds of opioid misuse (OR, 3.06; P<.001>

Limitations

  • Retrospective study.
  • The reasons for increased risk for opioid misuse were unclear.

Coauthored with Chitra Ravi, MPharm