(HealthDay News) — Each refill and week of opioid prescription following surgery is associated with an increasing risk of opioid misuse among opioid naive patients, according to a study published online in The BMJ.

Gabriel A Brat, MD, from the Beth Israel Deaconess Medical Center in Boston, and colleagues used surgical claims from a linked medical and pharmacy administrative database to identify 37,651,619 commercially insured patients (2008 to 2016), including 1,015,116 opioid naive patients undergoing surgery. Refills, total dosage, and duration of use of opioids after surgery were assessed.

The researchers found more than half of patients (56.0%) received postoperative opioids. A code for abuse was identified in less than 1% of patients (0.6%). The strongest predictor of misuse was total duration of opioid use, with each refill and additional week of opioid use associated with an adjusted increase in the rate of misuse (44.0 and 19.9% increase in hazard, respectively).

“The analysis quantifies the association of prescribing choices on opioid misuse and identifies levers for possible impact,” the authors write.

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Brat GA, Agniel D, Beam A, et al. Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study. BMJ 2018;360:j5790. doi:10.1136/bmj.j5790 [Published online January 17, 2018)