Treatment for Opioid Use Disorder Before Surgery Reduces Risk of Overdose, Hospitalization

Patients with opioid use disorder (OUD) who undergo surgery benefit from using medications for the treatment of OUD prior to surgery and reduce the risk of overdose or complications, according to a study presented at the Anesthesiology 2023 Annual Meeting in San Francisco, California.

“We know that OUD treatments are very effective in helping to prevent relapse, overdose, and death in nonsurgical patients, but our research is the first to show that they also may be remarkably effective in at-risk patients facing surgical stress and recovery pain that often is addressed with opioids,” Anjali Dixit, MD, MPH, a pediatric anesthesiologist at Stanford University, California, said in a press release. “This is helping us learn more about how to optimally treat OUD patients so that their surgical and post-surgical pain is well-controlled, while also making sure we are minimizing their risk of relapse and overdose.”

The researchers analyzed data of more than 4 million surgeries performed between 2008 and 2020. Overdoses and other complications (OUD-related hospitalizations or infections) that occurred within 3 months after surgery were reviewed during their analysis. The surgeries included 25 of the most common types, including knee and hip replacement.

Of the total, 26,827 surgeries were performed on patients with a history of OUD, 36% (n = 9,699) of patients used OUD medications before surgery and 64% (n = 17,128) did not use medication. The researchers found that patients with OUD who did not use medications were 4.2 times more likely to overdose or have an OUD-related complication/hospitalization than those who did not have the disorder. Patients with OUD who used OUD medications “did not experience a statistically different risk of opioid-related adverse events compared to those who did not have the disorder,” according to the study’s researchers.

“The national efforts to increase access to OUD medications is good news for people with OUD, including those who need surgery,” Dr Dixit concluded. “The next step is to determine if a particular medication or regimen is better than another.”

Reference:

Opioid use disorder treatment associated with decreased risk of overdose after surgery, suggests first-of-its kind study over 4 million surgeries. News release. American Society of Anesthesiologists; October 15, 2023. Accessed November 7, 2023. www.asahq.org/about-asa/newsroom/news-releases/2023/10/opioid-use-disorder-treatment