Long-Term Family Opioid Use Poses a High Risk of Adolescent Opioid Dependency Following Surgery

Adolescents and young adults who underwent surgery stand a higher risk of opioid dependency if long-term opioid use exists within their families, according to a study published in JAMA Surgery by researchers from the University of Michigan.

In this retrospective cohort study, researchers utilized insurance claims data generated by a commercial database from January 2010 to June 2016 to study 346,251 opioid-naïve patients, aged 13 to 21 (mean age, 17, 50.7% female), who underwent one of 11 surgical and dental procedures such as wisdom tooth extraction, appendix removal, hernia repair, and knee and shoulder surgery, and who were listed as dependents on a family insurance plan. Data from patients enrolled with private employer-based insurance plans were also included.

Family Member Use Affects the Young

The study implemented generalized estimating equations with robust SEs clustered at family level to model persistent opioid usage as a function of ongoing opioid use among family members; controlling for procedure, total morphine milligram equivalents of the initial prescription fill, as well as patient and family characteristics. Researchers defined opioid use in family members as having at least one (family member) who either filled a 120-day supply prescription or more during the 12 months prior to the procedure date or having filled three or more opioid prescriptions in the 90 days before a procedure.

Among the total number of studied patients, 74.3% had an initial opioid fill, and of those, 4.3% had a family member experiencing long-term opioid use. Prevalent opioid use occurred in 4.1% of patients with long-term opioid use in a family member compared with only 2.4% without family members using opioids long-term (OR=1.54; 95% CI, 1.39 to 1.71).

Opioid Association Remains Unclear

The study results suggested that long-term opioid use among family members is correlated with ongoing opioid use among naïve adolescents and young adults who underwent surgical and dental procedures. Whether the association is due to genetic predisposition, parenting behaviors, or simply the use of the opioid prescription by a member of the family, remains unclear, according to the study authors.

“We are trying to better understand what impacts a young adult’s risk of chronic opioid use after the first time they are prescribed an opioid,” researchers stated in a press release. They suggested providers discuss with families the potential hazards commonly associated with continued opioid use while facilitating help for patients still seeking refills in the subsequent months following a procedure.

They added that physicians “should screen young patients for long-term opioid use in their families and implement heightened efforts to prevent opioid dependence among patients with this important risk factor.”

Source: JAMA Surgery, EurekAlert