Study examines opiate use in orthopedic trauma patients

(HealthDay)—Orthopedic trauma patients with isolated musculoskeletal injuries are significantly more likely than the general population to have used prescription opiates prior to injury, and pre-injury use predicts prolonged postoperative use, according to a study published in the June 19 issue of The Journal of Bone & Joint Surgery.

Joel E. Holman, M.D., from the University of Utah in Salt Lake City, and colleagues queried the Utah Controlled Substance Database to examine usage of prescription opiates three months prior to injury and six months post-injury among 613 patients admitted to the orthopedic trauma service with isolated musculoskeletal injuries.

The researchers found that, in the three months prior to injury, 15.5 percent of patients with orthopedic trauma had filled a prescription for opiates, compared with 9.2 percent of the general population (P < 0.001). Significantly more trauma patients filled more than one prescription pre-injury versus the general population (12.2 versus 6.4 percent). After surgery, 68.4, 11.9, and 19.7 percent of patients filled opiate prescriptions for less than six weeks, for six to 12 weeks, and past 12 weeks, respectively. Pre-injury use of opiates correlated with a six-fold increase in the likelihood of use in the past 12 weeks and with a 3.5-fold increased likelihood of obtaining opiates from a provider other than the surgeon. Advancing age and extent of pre-injury use were risk factors for prolonged use of opiates.

"Patients with orthopedic trauma are significantly more likely than the general population to use prescription opiates prior to injury," the authors write. "Pre-injury opiate use is predictive of prolonged use post-injury and predictive of patients who will seek opiates from other providers."

One or more authors disclosed financial ties to a third party, in support of an aspect of this work.

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