opioid epidemic

study published in JAMA examined the frequency of opioid overdoses after discharge from surgery.

Researchers used data from the Clinformatics Data Mart (Optum), which includes annual claims data from a nationwide commercial payer for 13.5 million beneficiaries. They identified patients undergoing one of 22 surgical procedures from 2004 to 2015 who filled an opioid prescription within three days of discharge after the procedure. They did not include patients who had undergone an opioid overdose in the six months prior to the procedure.

Researchers examined 1.3 million patients who met the inclusion criteria. Of the 1.3 million, 134, or 0.01 percent, had an opioid overdose within 30 days of surgical discharge. The frequency of overdose decreased over time postoperatively, with 10.3 overdoses per 100,000 procedures within 30 days of surgical discharge and 3.2 overdoses per 100,000 procedures within 61 to 90 days after surgical discharge.

However, frequency of overdose rose with increase in opioid use preoperatively. While opioid-naïve patients experienced an overdose rate of 2.8 per 100,000 procedures, patients who took more than 100 mg of daily morphine equivalents experienced 142.8 overdoses per 100,000 procedures.

“This study demonstrated that opioid overdose after surgical discharge was rare,” study authors concluded.