Bottom Line: This study looked at 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 first time after common surgical or dental procedures. This observational study used data from a commercial insurance database for about 346,000 patients (ages 13 to 21) who underwent procedures including tooth extraction, appendectomy, hernia repair, and arthroscopic knee and shoulder surgery, and who were dependents on a family insurance plan. Among those patients, about 257,000 (74 percent) had their first opioid prescription filled. Of those patients with an initial opioid prescription filled, about 11,000 (4.3 percent) had a family member with long-term opioid use. Persistent opioid use (defined as one or more opioid prescription filled between 91 and 180 days after surgery among patients with an initial opioid prescription filled) occurred in 453 patients (4.1 percent) with a family member who was a long-term user of opioids compared with 5,940 patients (2.4 percent) without long-term opioid use by a family member. The findings suggest having a family member with long-term opioid use was associated with a higher likelihood of persistent opioid use by adolescents and young adults who are prescribed their first opioid. Physicians should screen young patients for long-term opioid use in their family. This study cannot explain the reasons for the association. And, the study included patients with private employer-based insurance so the findings may not be generalized to patients who are publicly insured or uninsured.
Authors: Jennifer F. Waljee, M.D., University of Michigan Medical School, Ann Arbor, and coauthors
(doi:10.1001/jamasurg.2018.5838)
Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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