As the nation continues to wrestle with the opioid epidemic, researchers at the University of Michigan Medical School examined whether long-term opioid use by one or more family members was associated with long-term opioid use by adolescents and young adults prescribed opioids for the for the first time after common surgical or dental procedures.
“We know from previous research that adolescents and young adults undergoing dental and other common surgical procedures are at risk of persistent opioid use after their first opioid prescription,” said senior author Jennifer Waljee, MD, Michigan Medicine and CS Mott Children’s Hospital surgeon and member of the Michigan Opioid Prescribing Engagement Network (Michigan-OPEN).
“Our study suggests a potential relationship between this risk among youth and the presence of opioid use among family members and may be an important consideration when screening for individuals at risk for prolonged postoperative opioid use,” Waljee said.
The observational study used data from a commercial insurance database of about 346,000 patients ages 13 to 21 who had procedures including wisdom tooth extractions, appendectomies, hernia repairs, and arthroscopic knee and shoulder surgery and who were dependents on a family insurance plan between 2010 and 2016.
Among those patients, about 257,000 or 74% had their first opioid prescription filled. Among those patients with an initial opioid prescription filled, about 11,000 or 4.3% had a family member with long-term opioid use.
Persistent opioid use, defined as one or more opioid prescriptions filled between 91 and 180 days after surgery among patients with an initial opioid prescription filled, occurred in 453 patients or 4.1% with a family member who was a long-term user of opioids compared to 5,940 patients or 2.4% without long-term opioid use by a family member.
The researchers say the findings suggest that having a family member with long-term opioid use was associated with a greater likelihood of persistent opioid use by adolescents and young adults who are prescribed their first opioid. They also say that physicians should screen young patients for long-term opioid use in their family.
However, the researchers say that the study cannot explain whether the association is due to genetics, parenting behaviors, or the use of the prescription by someone else in the family. Also, the study included patients with private employer-based insurance, so the findings may not be generalized to patients who are publicly insured or uninsured.
Still, the researchers say that providers should discuss the potential harms of continued opioid use such as addiction, overdose, and even death with families and provide help for patients still seeking refills three or more months after a procedure.
“We are trying to better understand what impacts a young adult’s risk of chronic opioid use after the first time they are prescribed an opioid,” said Calista Harbaugh, MD, a pediatric surgery researcher at the CS Mott Children’s Hospital and member of Michigan-OPEN. “Surgeons and providers should heighten efforts to prevent opioid dependence among patients with any potential risk factors.”