Incidence of persistent opioid use following traumatic injury

• Published in: Regional anesthesia and pain medicine Vol. 49; no. 2; pp. 79 - 86
• Main Authors: Mauck, Matthew C, Zhao, Ying, Goetzinger, Amy M, Tungate, Andrew S, Spencer, Alex B, Lal, Asim, Barton, Chloe E, Beaudoin, Francesca, McLean, Samuel A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 05.02.2024; BMJ Publishing Group LTD
• Subjects: Analgesics, Opioid; Analgesics, Opioid - therapeutic use; Burns; Cholecystectomy; CHRONIC PAIN; Codes; Datasets; Fractures; Hernias; Hospitalization; Humans; Incidence; Injuries; Insurance claims; Laparoscopy; Morphine; Narcotics; Opioid-Related Disorders - epidemiology; Original research; Orthopedics; Outcome Assessment, Health Care; Pain - drug therapy; Pain Management; Patients; Prescriptions; Regional anesthesia; Retrospective Studies; Risk Factors; Substance use disorder; Surgery; Trauma; Trauma care; United States > US; Analgesics, Opioid; CHRONIC PAIN; Outcome Assessment, Health Care; Pain Management
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2022-103662

IntroductionMajor traumatic injuries are a known risk factor for persistent opioid use, but data describing the relationship between specific traumatic injuries and opioid use is lacking.MethodsWe used insurance claims data from January 1, 2001 to December 31, 2020 to estimate the incidence of new persistent opioid use in three hospitalized trauma populations: individuals hospitalized after burn injury (3809, 1504 of whom required tissue grafting), individuals hospitalized after motor vehicle collision (MVC; 9041), and individuals hospitalized after orthopedic injury (47, 637). New persistent opioid use was defined as receipt of ≥1 opioid prescriptions 90–180 days following injury in an individual with no opioid prescriptions during the year prior to injury.ResultsNew persistent opioid use was observed in 12% (267/2305) of individuals hospitalized after burn injury with no grafting, and 12% (176/1504) of burn injury patients requiring tissue grafting. In addition, new persistent opioid use was observed in 16% (1454/9041) of individuals hospitalized after MVC, and 20% (9455/47, 637) of individuals hospitalized after orthopedic trauma. In comparison, rates of persistent opioid use in all trauma cohorts (19%, 11, 352/60, 487) were greater than the rates of persistent opioid use in both non-traumatic major surgery (13%) and non-traumatic minor surgery (9%).ConclusionsThese data demonstrate that new persistent opioid use frequently occurs in these common hospitalized trauma populations. Improved interventions to reduce persistent pain and opioid use in patients hospitalized after these and other traumas are needed.