Breaking News
January 23, 2019 - New certified reference material for testing residual solvents in cannabis
January 23, 2019 - Gene-edited chickens could prevent future flu pandemic
January 23, 2019 - Cardiovascular disease risk begins even before birth
January 23, 2019 - Younger patients receiving kidney transplant more likely to live longer, shows data
January 23, 2019 - Skin samples hold early signs of prion disease, research suggests
January 23, 2019 - Researchers discover how body initiates repair mechanisms that limits damage to myelin sheath
January 23, 2019 - Fecal transplant from certain donors better than others
January 23, 2019 - Risk for Uninsurance in AMI Patients Reduced With Medicaid Expansion
January 23, 2019 - Readmissions reduction program may be associated with increase in patient-level mortality
January 23, 2019 - Fostering translation and communication in medicine and beyond
January 23, 2019 - To Fight Fatty Liver, Avoid Sugary Foods and Drinks
January 23, 2019 - TPU scientists develop new implants that double the rate of bone lengthening in kids
January 23, 2019 - New sessions at Pittcon 2019
January 23, 2019 - Insilico to present latest findings in AI for Drug Discovery at 3rd Annual SABPA FTD Forum
January 23, 2019 - Opioid overdose patients can be safely discharged an hour after administration of naloxone
January 23, 2019 - Scientists find bacterial extracellular vesicles in human blood
January 23, 2019 - Researchers gain new insights into development of necrotizing enterocolitis in preemies
January 23, 2019 - Medical expert advises people with epilepsy not to stockpile medicines
January 23, 2019 - Study outlines research priorities for improving pediatric patient care and safety
January 23, 2019 - Bedfont to exhibit NObreath FeNO monitor at Arab Health 2019
January 23, 2019 - Nicotinamide riboside supplementation confers significant physiological benefits to mothers and offspring
January 23, 2019 - Increasing temperatures may help preserve crop nutrition
January 23, 2019 - Many Oncologists in the Dark About LGBTQ Health Needs
January 23, 2019 - Epigenetic change causes fruit fly babies to inherit diet-induced heart disease
January 23, 2019 - Erasing memories could reduce relapse rates among drug addicts
January 23, 2019 - African Americans who smoke cigarettes are more likely to develop peripheral artery disease
January 23, 2019 - Unique data combination helps FinnGen researchers to fund links between genetic factors and health
January 23, 2019 - Parents’ mental health problems associated with reactive attachment disorder in children
January 23, 2019 - Graphene Flagship project studies impact of graphene and related materials on our health
January 23, 2019 - The connection between the Pope and contraceptive pills
January 23, 2019 - Prior dengue infection could protect children from symptomatic Zika
January 23, 2019 - Previous dengue virus infection associated with protection from symptomatic Zika
January 23, 2019 - VISTA checkpoint implicated in pancreatic cancer immunotherapy resistance
January 23, 2019 - The Tiny Camera That Could Revolutionize Cardiovascular Surgery
January 23, 2019 - Peptide isolated from soil fungi has antitumor and antibacterial properties
January 23, 2019 - TGen identifies polio-like virus as potential cause of Acute Flaccid Myelitis outbreak
January 23, 2019 - Migrants and refugees do not bring disease and are at greater health risk themselves says WHO
January 23, 2019 - Examing the effects of menopause in workplace
January 23, 2019 - Enemy number 1 – Air pollution and climate change top of WHO agenda
January 23, 2019 - Two Positive Phase III studies of Tafenoquine for the Radical Cure of Plasmodium vivax Malaria Published in The New England Journal of Medicine
January 23, 2019 - World Trade Center responders at increased risk for head and neck cancers
January 23, 2019 - Low-sugar diet leads to significant improvement in nonalcoholic fatty liver disease in boys
January 23, 2019 - Chaos in bodily regulation can optimize our immune system, finds study
January 23, 2019 - Short, text-based exercises can increase happiness for adults recovering from substance use disorders
January 23, 2019 - Body size may have greater influence on women’s lifespan than men
January 23, 2019 - Groundbreaking tool helps visualize neuronal activity with near-infrared light
January 23, 2019 - Prior dengue immunity in children may be protective against symptomatic Zika
January 23, 2019 - Holocaust survivors with PTSD and their offspring exhibit more unhealthy behavior patterns
January 23, 2019 - Scientists discover new genetic mutations causing inherited deaf-blindness
January 23, 2019 - UC team designs new naloxone-dispensing smart device
January 23, 2019 - Torrent Pharmaceuticals Limited Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium and Hydrochlorothiazide Tablets, USP
January 23, 2019 - Brain activity shows development of visual sensitivity in autism
January 23, 2019 - Two hour gap between dinner and sleep is overrated says Japanese research
January 23, 2019 - Fear and embarrassment are causing smear test numbers to plummet
January 23, 2019 - Protein-secreting device implanted in epileptic rats reduces seizures, improves cognition
January 23, 2019 - Reintroduction project recovers current wild population of green turtle in Cayman Islands
January 23, 2019 - Cancer survivors face greater financial burden related to medical bills
January 23, 2019 - PSA screening reduces prostate cancer deaths by 30%
January 23, 2019 - LSTM receives grant to help improve health of people living in informal settlements
January 23, 2019 - Hemochromatosis Mutation Linked to Other Morbidity
January 23, 2019 - Why early diagnosis of autism should lead to early intervention
January 23, 2019 - Aspirin May Lower Stroke Risk in Women with History of Preeclampsia
January 23, 2019 - Exposure to certain chemicals may be linked to decrease in blood pressure during pregnancy
January 23, 2019 - Bowel cancer on the rise among younger Australians
January 23, 2019 - Scientists have reversed memory loss in a mouse model of Alzheimer’s
January 23, 2019 - Defective molecular master switch could lead to age-related macular degeneration
January 23, 2019 - Researchers identify how concussions may contribute to seizures
January 23, 2019 - Short interval between last meal of the day and bedtime may not affect blood glucose levels
January 23, 2019 - Still Too Many Highway Deaths Tied to Speeding
January 23, 2019 - Prenatal valproate exposure linked to increased ADHD risk
January 23, 2019 - Compound identified that may help treat heart failure
January 23, 2019 - Undiagnosed Asthma in Urban Adolescents May Be Common
January 23, 2019 - Study describes metabolism of intestinal microbiota in babies for the first time
January 22, 2019 - Study links concussions to development of epilepsy
January 22, 2019 - Specialist-led hospital bereavement service may help restrain legal action after difficult deaths
January 22, 2019 - Genetic study reveals possible new routes to treating osteoarthritis
January 22, 2019 - Blood test may detect early signs of lung-transplant rejection
January 22, 2019 - Blood marker could aid in early prediction of Alzheimer’s progression
January 22, 2019 - Orthodontic treatment does not guarantee future dental health
January 22, 2019 - Rutgers researchers discover cause of bone loss in people with joint replacements
1 in 7 patients at risk for persistent opioid use after lung surgery

1 in 7 patients at risk for persistent opioid use after lung surgery

image_pdfDownload PDFimage_print

While the use of opioids after surgery is intended as a short-term strategy to relieve pain, many patients who weren’t prior opioid users continue to take the medication for several months after their lung operations, becoming dependent and “persistent opioid users,” according to research presented today at the 54th Annual Meeting of The Society of Thoracic Surgeons.

“We hope that patients gain awareness that long-term usage of opioids after surgery can be a serious and prevalent problem,” said lead author Alexander A. Brescia, MD, of the University of Michigan, Ann Arbor. “Surgeons are at the forefront of the opioid crisis as the main prescribers of these medications following surgery. Our research attaches data to this epidemic and hopefully provides a clear characterization of the issue and highlights ways to combat the crisis, with important roles for both surgeons and patients.”

Dr. Brescia and colleagues evaluated data from cancer patients between January 2010 and June 2014, using insurance claims from the Truven Health MarketScan database. The database contains information from more than 100 health plans in the United States. A total of 3,026 patients who received an operation to remove part of the lung (lung resection) and were “opioid naïve” were included in this study.

The researchers found that 1 in 7 patients (14%) became new persistent opioid users after surgery, establishing opioid addiction as a postoperative complication that is as common as others, including atrial fibrillation. According to Dr. Brescia, “new persistent opioid users” describes patients who were not taking opioids before surgery, underwent surgery, took opioid pain medication, and continued to use the opioid prescription after the operation, even after all wounds had healed and physical recovery was complete.

“This research highlights one pathway for long-term opioid use: opioid users who begin taking the pills following a surgical operation,” said Dr. Brescia.

According to David T. Cooke, Head of General Thoracic Surgery at the University of California Davis in Sacramento, who was not directly involved with this study, the research presented by Dr. Brescia is a well performed and important investigative analysis. “This study confirms in the US health system what has been observed in international health systems, specifically Canada, that thoracic surgery has a high prevalence for postoperative chronic opioid use in patients who were previously opioid naïve. The research highlights unintended contributions of thoracic surgery to the opioid epidemic and provides an opportunity for thoracic surgeons to be leaders and change makers in ending the national opioid crisis.”

Open Lung Surgery versus VATS

The research also indicated that patients who underwent an open, traditional lung resection with a large incision had nearly double the risk of becoming long-term opioid users in comparison to those who received their operations via a minimally invasive approach such as video-assisted thoracoscopic surgery (VATS). The researchers found that 17% of patients who underwent a traditional lung operation became new persistent opioid users, compared to 9% of the patients who received a minimally invasive lung surgery.

Risk Factors of Opioid Overuse

Open operation was determined to be only one of many risk factors for persistent opioid use. Also associated with a higher risk of developing an opioid dependency were male sex, age of less than 64 years, income of less than $70,000, past history of substance abuse, hospital stay of more than 5 days after surgery, and postoperative chemotherapy/radiation.

“Our research reveals the need to further examine specific risk factors that lead to persistent opioid usage after surgery, as well as the importance of determining appropriate prescribing guidelines and improving patient education,” said Dr. Brescia.

The researchers suggested that strategies be developed and standardized among all caregivers to educate patients about important issues such as the details of surgical operations, the risks of using opioids, alternatives to opioids for pain management, managing expectations for pain after surgery, and instructions for proper disposal of unused pills.

“It is vitally important to discuss pain management with your surgeon and other health care providers prior to surgery,” said Dr. Brescia. “Taking opioids for pain following an operation could put patients at risk of becoming dependent or addicted to these medications. Together with their surgeons, patients should develop a plan to appropriately manage their pain while also minimizing their risk of taking these medications for longer than intended after surgery.”

According to the US Centers for Disease Control and Prevention (CDC), the amount of opioid prescriptions in the US peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons. The rates have decreased since, but despite these reductions, the amount of opioids prescribed remains high. The CDC reports that in 2016, the total number of prescriptions dispensed in the US was more than 214 million, with a prescribing rate of 66.5 prescriptions per 100 persons. The generous prescribing habits of clinicians is particularly important, as CDC data also show that 40% of all US opioid overdose deaths involve a prescription opioid.

Source:

http://sts.org/media/news-releases/1-7-lung-surgery-patients-risk-opioid-dependence

Tagged with:

About author

Related Articles