Prescribing opioids after low-acuity urological surgeries potentially leads to long-term narcotic dependence, according to study findings presented at the Canadian Urological Association 74th annual meeting in Quebec City.
Jeffrey D. Campbell, MD, of Western University in London, Ontario, and collaborators identified 91,083 men who underwent their first vasectomy (78%), transurethral prostatectomy, urethrotomy, circumcision, spermatocelectomy, or hydrocelectomy in Ontario during the years 2013 to 2016. One in 3 (35%) patients filled an opioid prescription within 5 days of their procedure. Codeine was prescribed in 70% of cases, mostly by urologists (81%).
Overall, 1.6% of patients continued to take narcotics long term, filling at least 2 prescriptions 9 to 15 months after surgery. Refillers were a significant 40% more likely to become long-term users. Furthermore, they had triple the risk for overdose than nonusers.
Opioid users did not differ markedly from nonusers in chronic pain, according to comparisons of 25 comorbidities and 16 markers for health care utilization. Men with cancer, concurrent procedures, a prolonged hospital stay, or pre-existing opioid use were excluded from analyses.
“The opioid abuse epidemic is changing the way the medical community uses narcotics,” Dr Campbell and his team commented in a study abstract. “Physicians prescribing opioids after low-pain-intensity surgery is a significant risk factor for potential narcotic dependence; [therefore] efforts should be made to reduce postoperative narcotic use, especially for procedures that should have minimal postoperative pain.”
Campbell J, McClure A, Clarke C, et al. Opioid prescription to patients after low-acuity urological surgery is a risk factor for long-term opioid use. Presented at the 2019 Canadian Urological Association 74th annual meeting held June 29-July 1 in Quebec City. Abstract POD-2.1.